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1 Department of Geriatric Medicine and Metabolic Diseases and 2 Institute of Endocrinology-II, University of Napoli, 80138 Naples, Italy
In 70 healthy
subjects with a large age range, the relationships between plasma tumor
necrosis factor-
(TNF-
) and body composition, insulin action, and
substrate oxidation were investigated. In the cross-sectional study
(n = 70), advancing age correlated
with plasma TNF-
concentration (r = 0.64, P < 0.001) and whole body glucose disposal (WBGD; r=
0.38, P < 0.01). The
correlation between plasma TNF-
and age was independent of sex and
body fat (BF; r = 0.31, P < 0.01). Independent of age and
sex, a significant relationship between plasma TNF-
and leptin
concentration (r = 0.29, P < 0.02) was also found. After
control for age, sex, BF, and waist-to-hip ratio (WHR), plasma TNF-
was still correlated with WBGD (r =
0.33, P < 0.007). Further
correction for plasma free fatty acid (FFA) concentration made the
latter correlation no more significant. In a multivariate analysis, a
model made by age, sex, BF, fat- free mass, WHR, and plasma TNF-
concentrations explained 69% of WBGD variability with age
(P < 0.009), BF
(P < 0.006), fat-free mass
(P < 0.005), and plasma TNF-
(P < 0.05) significantly
and independently associated with WBGD. In the longitudinal study, made
with subjects at the highest tertiles of plasma TNF-
concentration
(n = 50), plasma TNF-
concentration
predicted a decline in WBGD independent of age, sex, BF, WHR
[relative risk (RR) = 2.0; 95% confidence intervals (CI) = 1.2-2.4]. After further adjustment for plasma fasting FFA
concentration, the predictive role of fasting plasma TNF-
concentration on WBGD (RR = 1.2; CI = 0.8-1.5) was no
more significant. In conclusion, our study demonstrates that plasma
TNF-
concentration is significantly associated with advancing age
and that it predicts the impairment in insulin action with advancing
age.
insulin action; substrate oxidation
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