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Adipocytokines and the metabolic syndrome among older persons with and without obesity: the InCHIANTI study
Authors:Sari Stenholm  Annemarie Koster  Dawn E. Alley  Marjolein Visser  Marcello Maggio  Tamara B. Harris  Josephine M. Egan  Stefania Bandinelli  Jack M. Guralnik  Luigi Ferrucci
Affiliation:1. Clinical Research Branch, National Institute on Aging, Baltimore, MD, USA;2. Division of Welfare and Health Policies, National Institute for Health and Welfare, Helsinki, Finland;3. Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda;4. Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD, USA;5. Faculty of Earth and Life Sciences, EMGO Institute, VU University Medical Center, Institute of Health Sciences, VU University Amsterdam, Amsterdam, The Netherlands;6. Department of Internal Medicine and Biomedical Sciences, Section of Geriatrics, University of Parma, Parma, Italy;7. Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, MD, USA;8. Geriatric Unit, Azienda Sanitaria di Firenze, Florence, Italy
Abstract:Objectives Adipose tissue‐derived inflammation may contribute to metabolic alterations and eventually to the metabolic syndrome (MetS). The purpose of this study was to: (1) examine the role of adipocytokines in the association between obesity and the MetS and (2) to determine whether the association is different in obese and non‐obese persons. Design Cross‐sectional population‐based InCHIANTI study. Subjects A total of 944 community‐dwelling adults aged 65 years and older living in Tuscany, Italy. Measurements Obesity was defined as body mass index ≥30 kg/m2 and MetS as ≥3 of the ATP‐III criteria. Circulating levels of C‐reactive protein, interleukin (IL)‐6, IL‐1 receptor antagonist (IL‐1ra), IL‐18, tumour necrosis factor (TNF)‐α R1, adiponectin, resistin and leptin were measured. Additionally, insulin resistance was determined using the homeostasis model assessment (HOMA‐IR). Results The prevalence of the MetS was 32%. Both overall and abdominal obesity were significantly associated with the MetS after adjusting for inflammatory cytokines, adipokines and lifestyle factors. After adjusting for multiple confounders and HOMA‐IR, IL‐1ra, TNF‐α R1 and adiponectin (P < 0·05) remained significantly associated with the MetS. Having multiple cytokines in the highest tertile increased the likelihood of having the MetS in both obese (P for trend 0·002) and non‐obese persons (P for trend 0·001) independent of insulin resistance. Conclusions Non‐obese and obese individuals who develop an intense pro‐inflammatory state may be more prone to develop the MetS than those with lower levels of inflammation.
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