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Sex differences in the association between antinuclear antibody positivity with diabetes and multimorbidity in older adults: Results from the Baltimore Longitudinal Study of Aging.

ABSTRACT: Antinuclear antibodies (ANA), a marker of self-reactivity to DNA and other nuclear antigens, are present in several autoimmune diseases and have been observed in healthy persons in the absence of autoimmune disease. ANA prevalence is higher in women and older adults, but the health implications of ANA in middle- to older-aged adults are unknown. Immune system differences by sex may further result in sex-specific susceptibility to morbidity. In a cross-sectional analysis of data from the Baltimore Longitudinal Study of Aging, we examined the sex-specific relationship between age and ANA as well as the associations (odds ratios and 95% confidence intervals) between ANA and type-2 diabetes and multimorbidity (2 or more chronic diseases), stratified by sex and controlling for age and race. ANA was measured in a 1:160 dilution of sera by immunofluorescence using HEp-2 cells (seropositive = 3 or 4). Overall ANA seroprevalence was 12% (15.1% in women, 8.8% in men). We observed a non-linear relationship between age and ANA that varied by sex (interaction p-value < 0.05), with a clear sex differences in younger participants (ages 48-59), which converged in the oldest (age 80+). ANA positive women had higher odds of type 2 diabetes (OR: 2.06, 95% confidence interval: 1.04, 4.07) and multimorbidity (OR: 2.47, 95% confidence interval 1.11, 5.50) than women who were ANA negative. No statistically significant associations were observed in men. Insight into differences in age-related ANA positivity and ANA associations with chronic diseases by sex is important for understanding the impact of immune dysregulation in aging individuals.

SUBMITTER: Meier HCS

PROVIDER: S-EPMC7180125 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundMultimorbidity among older adults, which is associated with added functional decline and higher health care utilization and mortality, has become increasingly common with the dramatic acceleration of ageing in China. The purpose of this study was to reveal age, sex, residence, and region- specific prevalence and patterns of multimorbidity among older adults in China.MethodsThis study is based on the 2018 Chinese Longitudinal Health Longevity Survey (CLHLS), the most recent edition of this national survey, and involved analysis of 15,275 participants aged 65 years and older. Multimorbidity was defined as an individual who has two or more chronic diseases or conditions and was divided into two types for analysis: ≥2 (MM2+) and ≥ 3 (MM3+). Fourteen chronic diseases or conditions surveyed were used to assess patterns of multimorbidity through association rule mining.ResultsAmong the 15,275 participants, the largest proportion (39.9%) was 90 years old and over, while the distribution of sex and residence is roughly the same. Overall, the prevalence of multimorbidity was 44.1% for MM2+ and 22.9% for MM3+. The most frequently occurring patterns were two or three combinations between hypertension, cardiovascular diseases and affective disorders. Cardiovascular diseases combined with diabetes or dyslipidemia showed the most predominant association in different age groups. Moreover, the prevalence of the hypertension +diabetes pattern decreased with age. The strongest associations were found for the clustering of hypertension + cardiovascular diseases + respiratory diseases in males, however, among females it was the cardiovascular diseases + diabetes cluster. Cardiovascular diseases + rheumatoid arthritis + visual impairment was observed in urban areas and hypertension + cardiovascular diseases + affective disorders in rural areas. The most distinctive association rule in Northern China was {cardiovascular diseases, hypertension, visual impairment} = > {diabetes}. Respiratory disease was more prevalent in combination with other systemic disorders in Western China, and affective disorders in Southern China.ConclusionsThe prevalence of multimorbidity among older Chinese was substantial, and patterns of multimorbidity varied by age, sex, residence, and region. Future efforts are needed to identify possible prevention strategies and guidelines that consider differences in demographic characteristics of multimorbid patients to promote health in older adults.

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Sex differences in the association between antinuclear antibody positivity with diabetes and multimorbidity in older adults: Results from the Baltimore Longitudinal Study of Aging.

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