Associations Between Inflammation and Physical Function in African Americans and European Americans with Prevalent Cardiovascular Risk Factors.
To examine associations between inflammation and physical function and potential mediation by white matter hyperintensities (WMHs) in African Americans (AAs) and European Americans (EAs).



Cross-sectional analysis using linear and logistic models with generalized estimating equations to account for family clustering, reporting results as regression coefficients (β) and odds ratios (ORs) adjusted for education, alcohol, exercise, body mass index, hypertension, diabetes mellitus, heart disease, cognition, ankle-brachial index, race (site), and supported interactions.



Genetic Epidemiology Network of Arteriopathy-Genetics of Microangiopathic Brain Injury Study cohort.



AA and EA sibships with two or more siblings with hypertension before age 60 (N = 1,960; 65% female, 51% AA, aged 26-91, 50% obese, 72% hypertensive).



Inflammation (C-reactive protein (CRP), interleukin-6 (IL6), soluble tumor necrosis factor receptors (sTNFRs) 1 and 2, WMH volume (cm(3) ) according to magnetic resonance imaging), walking speed (cm/s) over 25 feet, and mobility difficulty (any self-reported difficulty walking half a mile).



In separate models, inflammatory markers were associated with walking speed (sTNFR1: β = -2.74, P < .001; sTNFR2: β = -1.23, P = .03; CRP: β = -1.95, P = .001; IL6: β = -1.24, P = .03) and mobility difficulty (sTNFR1: OR = 1.36, P = .001; sTNFR2: OR = 1.25, P = .005; CRP: OR = 1.22, P = .005; IL6: OR = 1.18, P = .02); the association between WMH volume and sTNFR1 in AA (β = 0.07, P = .06) did not reach typical statistical thresholds. WMH volume was associated with walking speed in AA (β = -3.17, P = .02) but not with mobility difficulty (OR = 1.10, P = .54). Adjusting for WMH did not change associations.



In young, middle-aged, and older adults with prevalent cardiovascular risk factors, multiple inflammatory biomarkers were associated with slower walking speed independent of microvascular disease in the brain. There was little evidence of mediation by brain WMH volume. Inflammation may contribute to physical function impairments through pathways other than brain microvascular disease, particularly in AAs.
Division of Geriatrics, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi.
B Gwen
BG
Windham
School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi.
Steven R
SR
Wilkening
Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, Mississippi.
Seth T
ST
Lirette
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Iftikhar J
IJ
Kullo
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota.
Stephen T
ST
Turner
Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, Mississippi.
Michael E
ME
Griswold
Division of Geriatrics, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi.
Thomas H
TH
Mosley
D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000208:ethnology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000208:ethnology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D010809:Physical Fitness; D015995:Prevalence; D012307:Risk Factors; D000072797:Walking Speed; D066127:White Matter / Q000473:pathology*; D044465:White People
D015415:Biomarkers
ethnicity; inflammation; physical function; white matter hyperintensity