Durham, NC, United States
Durham, NC, United States

Time filter

Source Type

Huffman K.M.,Veterans Affairs Medical Center | Huffman K.M.,Duke University | Pieper C.F.,Center for Aging and Human Development | Kraus W.E.,Center for Aging and Human Development | And 4 more authors.
Journals of Gerontology - Series A Biological Sciences and Medical Sciences | Year: 2011

Background. We wished to determine if a marker of endothelial dysfunction/activation soluble vascular cell adhesion molecule (s-VCAM)-was related to functional status and mortality in community-dwelling older adults independent of the known effects of markers of inflammation and coagulation. Methods. Data came from the third and fourth in-person waves of the Duke Established Populations for Epidemiologic Studies of the Elderly. Participants (aged ≥ 71 years) had participated in a blood draw (N = 1,551) from which concentrations of s-VCAM, interleukin-6, and D-dimer were determined. Information was gathered in-person on demographics, health behaviors, chronic health conditions, and functional status (Katz, Rosow-Breslau, Nagi). Death was determined through the National Death Index. Multivariable regression analysis was used to examine the adjusted association of s-VCAM with functional status; Cox proportional hazards models ascertained hazard of mortality.Results. Controlled analyses indicated that cross-sectionally, but not longitudinally (4 years later), greater s-VCAM concentrations were associated with poorer function as measured by the Katz and Rosow-Breslau scales (p <. 05 for both), independent of interleukin-6 and D-dimer. In controlled analyses, s-VCAM (p =. 002), D-dimer (p =. 008), and interleukin-6 (p =. 01) were independently related to 4-year mortality; 1 SD increase in log concentration conferred 1.2-, 1.1-, and 1.2-fold increases in mortality, respectively. The greatest hazard of mortality was observed within the first year after measurement. s-VCAM concentrations were not predictive of 15-year mortality.Conclusions.Independent of inflammation and coagulation markers, endothelial dysfunction serves as a marker of, and potentially contributes causally to, poor function and death in community-dwelling older adults. © 2011 The Author.


Redman L.M.,Pennington Biomedical Research Center | Huffman K.M.,Veterans Affairs Medical Center | Landerman L.R.,Center for Aging and Human Development | Pieper C.F.,Center for Aging and Human Development | And 8 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2011

Objectives: The objective of the study was to evaluate whether serum concentrations of metabolic intermediates are related to adiposity and insulin sensitivity (Si) in overweight healthy subjects and compare changes in metabolic intermediates with similar weight loss achieved by diet only or diet plus exercise. Design: This was a randomized controlled trial. Participants and Intervention: The cross-sectional study included 46 (aged 36.8±1.0 yr) overweight (body mass index 27.8 ± 0.7 kg/m2) subjects enrolled in a 6-month study of calorie restriction. To determine the effect of diet only or diet plus exercise on metabolic intermediates, 35 subjects were randomized to control (energy intake at 100% of energy requirements); CR (25% calorie restriction), or CR+EX: (12.5% CR plus 12.5% increase in energy expenditure by exercise). Main Outcome Measures: Serum concentrations of eight fatty acids, 15 amino acids, and 45 acylcarnitines (ACs) measured by targeted mass spectrometry. Results: In overweight subjects, the concentrations of C2 AC and long-chain ACs were positively associated with percent fat (R 2=0.75, P=0.0001) and Si (R2=0.12, P=0.05). The percent fat (R2= 0.77, P < 0.0001), abdominal visceral fat (R2 = 0.64, P < 0.0001), and intrahepatic fat (R2 = 0.30, P = 0.0002) were positively associated with fatty acid concentrations. There was a significant increase in an AC factor (comprised of C2 and several medium chain ACs) in the CR group (P=0.01). Conclusion: In nonobese subjects, fasted serum ACs are associated with Si and fat mass. Despite similar weight loss, serum ACs increase with CR alone but not CR+EX. A greater improvement in Si with weight loss during CR+EX interventions may be related to improved coupling of β-oxidation and tricarboxylic acid cycle flux induced by exercise. Copyright © 2011 by The Endocrine Society.

Loading Center for Aging and Human Development collaborators
Loading Center for Aging and Human Development collaborators