Immune and Nutrition Status in Elderly Koreans with HyperLDL-Cholesterolemia

Abstract

Summary Although the effects of nutrition and immune status on disease development have been investigated, little attention has been given to changes in immune function in the elderly vulnerable to coronary artery disease (CAD). Our objective was to evaluate the association between immune variables and CAD risk factors, and nutritional factors related to immune and lipid profiles in elderly Koreans ( n ϭ 90). The subjects were divided into three groups based on serum low-density lipoprotein cholesterol (LDL-cholesterol) level: risk ( Ն 160 mg/dL), borderline (130-160 mg/dL), and control groups ( Ͻ 130 mg/dL). Concanavalin A-induced lymphocyte proliferation rate and interleukin (IL)-2 secretion were significantly lower in the risk group than the control group. The subjects in the risk group showed the highest serum concentrations of proinflammatory mediators such as complement 3 (C3), IL-1 ␤ , and IL-1 receptor antagonist (IL-1RA). The nutrient intake status of the subjects was generally satisfactory without differences among groups. IL-1RA concentration was negatively associated with intake of vitamin E and C3 was positively related to intake of Ca and Fe in the subjects with LDL-cholesterol Ն 130 mg/dL. This study suggests that elderly individuals with high serum LDL-cholesterol are in a mild chronic inflammation state and micronutrient status such as vitamin E, Ca, and Fe may relate to this state. Key Words immune function, nutritional factor, elderly, T-lymphocytes, cytokines Coronary artery disease (CAD) is a leading cause of death in elderly Koreans ( 1 ). Lipid metabolism and inflammatory responses are now recognized as factors playing a central role in the pathogenesis of CAD. In particular, LDL particles trapped in an intima undergo progressive oxidation and are internalized by macrophages and become foam cells, resulting in the formation of fatty streaks and fibrous plaque. These lesions are advanced and activated by growth factors and cytokines secreted from endothelial cells, smooth muscle cells, macrophages, and platelets ( 2-4 ).Cytokines are regulators of host responses to infection, inflammation, and trauma. The production and activity of the cytokines are tightly controlled. The main pro-inflammatory cytokines, such as interleukin (IL)-1 ␤ , IL-6, and tumor necrosis factor (TNF), are increased in the process of CAD. Inflammatory cytokines themselves were shown to be major inducers of their own soluble receptors/antagonist upregulation ( 5 ). For example, IL-1 receptor antagonist (IL-1RA), a protein with high homology with IL-1 but without IL-1 activity ( 6 ), was induced by inflammatory mediators. Serum levels of soluble cytokine receptors were reported to correlate with disease activity in a variety of clinical situations.Nutrition is an important factor affecting the cytokine level and inflammation response. Since diet is modifiable, nutrition could play a role in controlling CAD. It is of interest to evaluate the inflammatory response in elderly subjects with risk factors for CAD. In this stud...

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