Associations Between Fibrin D‐Dimer, Markers of Inflammation, Incident Self‐Reported Mobility Limitation, and All‐Cause Mortality in Older Men

Abstract

ObjectivesTo examine the independent relationships between fibrin D-dimer, interleukin 6 (IL-6), C-reactive protein (CRP), and fibrinogen and incident mobility limitation and mortality.DesignProspective.SettingGeneral practice in 24 British towns.ParticipantsMen aged 60 to 79 without prevalent heart failure followed up for an average of 11.5 years (N = 3,925).MeasurementsAll-cause mortality (n = 1,286) and self-reported mobility disability obtained at examination in 1998 to 2000 and in a postal questionnaire 3 to 5 years later in 2003.ResultsHigh D-dimer (top vs lowest tertile: adjusted odds ratio (aOR) = 1.46, 95% confidence interval = 1.02–2.05) and IL-6 (aOR = 1.43, 95% CI = 1.01–2.02) levels (but not CRP or fibrinogen) were associated with greater incident mobility limitation after adjustment for confounders and prevalent disease status. IL-6, CRP, fibrinogen, and D-dimer were significantly associated with total mortality after adjustment for confounders. Only D-dimer and IL-6 predicted total mortality independent of each other and the other biomarkers. The adjusted hazard ratio (aHR) was 1.16 (95% CI = 1.10–1.22) for a standard deviation increase in log D-dimer and 1.10 (95% CI = 1.04–1.18) for a standard deviation increase in log IL-6. D-dimer was independently related to vascular and nonvascular mortality, and IL-6 was independently related to vascular mortality. Risks of mobility limitation and mortality were greatest in those with a combination of high D-dimer and IL-6 levels.ConclusionD-dimer and IL-6 are associated with risk of mobility limitation and mortality in older men without heart failure. The findings suggest that coagulation leads to functional decline and mortality s that inflammation does not explain.

Inflammatory Markers and the Risk of Hip and Vertebral Fractures in Men: the Osteoporotic Fractures in Men (MrOS)

“…Elevated cytokines have been associated with loss of muscle mass, (30) poor mobility, (31) and disability. (32) In our study, men with three or more cytokines in the top quartile had slower gait speed. Nevertheless, addition of gait speed to the multivariable model had no effect on results.…”

Plasma citrulline measurement in the diagnosis of acute mesenteric ischaemia

“…The high levels of D‐dimer and lactate were in agreement with the literature. D‐dimer increases in almost all acute medical conditions involving thrombosis, ischaemia and inflammation, whereas serum lactate levels generally increase in all conditions that cause prolonged and severe tissue hypoperfusion, which is the case in AMI. The value of a parameter as an early diagnostic tool for AMI depends on its quantity, mechanism of release, clearance from serum and specificity for the intestine.…”

Levels of interleukin-1 beta can predict response to tocilizumab therapy in rheumatoid arthritis: the PETITE (predictors of effectiveness of tocilizumab therapy) study

“…The D-dimer antigen is a unique marker of fibrin degradation that is formed by the sequential action of the enzymes thrombin, factor XIIIa and plasmin. D-dimer is also an acute-phase reactant, with production stimulating high levels of cytokines such as IL-6 [24,25]. Levels of D-dimer are measured in some scenarios, notably to exclude venous thromboembolism (VTE) [36].…”

“…Among those biomarkers, IL-1β was selected as an important mediator of inflammatory response [2,3]. Fibrinogen and D-dimer were chosen because they are regulated by IL-6 [22][23][24][25]. The clinical outcomes of continuing tocilizumab therapy for 52 weeks were assessed as changes in disease activity score (DAS)-28 ESR and clinical disease activity index (CDAI) between baseline and after 52 weeks of tocilizumab therapy.…”