OBJECTIVES
To examine associations of inflammation with physical function and potential mediation by white matter hyperintensities (WMH) in African-Americans (AA) and European-Americans (EA).
DESIGN
Cross-sectional analysis using linear and logistic models with Generalized Estimating Equations to account for familial clustering, reporting results as regression coefficients (β) and odds ratios (OR) adjusted for education, alcohol, exercise, BMI, hypertension, diabetes, heart disease, cognition, ankle brachial index, race-site and supported interactions.
SETTING
Genetic Epidemiology Network of Arteriopathy-Genetics of Microangiopathic Brain Injury Study cohort.
PARTICIPANTS
AA and EA sibships, ≥2 siblings with hypertension before age 60 (n=1960; 65% female, 51% AA, age 26–91y, 50% obese, 72% hypertensive).
MEASUREMENTS
Inflammation
C-reactive protein (CRP), interleukin-6 (IL6), soluble tumor necrosis factor receptors [sTNFR] 1 and 2; magnetic resonance imaged WMH volumes (cm3). Walking speed (cm/second) over 25 feet and mobility difficulty (any self-reported difficulty walking ½ mile).
RESULTS
In separate models, inflammatory markers were associated with walking speed (sTNFR1: β=−2.74, p<.001; sTNFR2: −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); WMH was associated marginally only with sTNFR1 in AA (β=0.07, p=0.06). WMH were associated with walking speed in AA (AA: (β=−3.17, p=0.017; EA: β=−2.23, p=0.17) but not with mobility difficulty (OR=1.10, p=.54). Adjusting for WMH did not change associations.
CONCLUSION
In young-to-old persons 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 for mediation by brain WMH. Inflammation may contribute to physical function impairments through pathways other than brain microvascular disease, particularly in AA.