McCarthy Kevin, Laird Eamon, O'Halloran Aisling M, Fallon Padraic, Ortuño Román Romero, Kenny Rose Anne
School of Medicine, Trinity College Dublin, Dublin 2, Ireland; Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, Ireland.
School of Medicine, Trinity College Dublin, Dublin 2, Ireland.
Exp Gerontol. 2023 Feb;172:112056. doi: 10.1016/j.exger.2022.112056. Epub 2022 Dec 13.
Metabolic syndrome (MetS) is a risk factor for cardiovascular disease, diabetes, and all-cause mortality. Frailty is a condition of decreased multi-system physiological reserve where one has increased vulnerability to stressors. This study aimed to examine if MetS is associated with prevalent and incident frailty over a 4-year follow-up period in an aged population.
This study used data from waves 1 (2009-2011) and 3 (2014-2015) of The Irish Longitudinal Study on Ageing. Those aged <50 years or without baseline health assessment data were excluded. Baseline MetS status was determined using the National Cholesterol Education Program Third Adult Treatment Panel criteria. Frailty status was identified at both waves, operationalised using Fried's frailty phenotype (FP) and Rockwood's frailty index (FI). Ordinal logistic regression examined the cross-sectional association between MetS and prevalent frailty status. Those with prevalent pre-frailty or frailty were excluded and ordinal logistic regression models examined the association between MetS and incident frailty. Lastly, MetS' longitudinal associations with the five individual components of Fried's FP were examined. Models were adjusted for age, sex, education, smoking, chronic disease history and renal function.
Ordinal logistic regression models (n > 5100), showed MetS was associated with prevalent frailty as assessed by both FP (odds ratio (OR) 1.29, p < 0.001) and FI (OR 1.65, p < 0.001). Of those who were non-frail at baseline, 2247 participants had longitudinal FP data, while 3546 participants had longitudinal FI data. Models demonstrated that MetS was associated with an increased likelihood of incident frailty for both FP (OR 1.57, p < 0.001) and FI (OR 1.29, p = 0.014). MetS was found to be associated with incident low physical activity (OR 1.57, p = 0.001) and incident unintentional weight loss (OR 1.59, p = 0.025).
MetS in those ≥50 years was found to be associated with an increased likelihood of incident frailty over a 4-year period, by 57 % when measured by FP and 29 % by FI. MetS should be considered a risk factor for frailty and be taken into considered in any comprehensive geriatric assessment given frailty's dynamic nature and MetS being potentially modifiable.
代谢综合征（MetS）是心血管疾病、糖尿病和全因死亡率的危险因素。衰弱是一种多系统生理储备下降的状态，在此状态下个体对应激源的易感性增加。本研究旨在探讨在老年人群中，MetS在4年随访期内是否与现患衰弱和新发衰弱相关。
本研究使用了爱尔兰老龄化纵向研究第1波（2009 - 2011年）和第3波（2014 - 2015年）的数据。年龄<50岁或无基线健康评估数据的个体被排除。使用美国国家胆固醇教育计划成人治疗专家组第三次报告的标准确定基线MetS状态。在两波研究中均确定衰弱状态，采用Fried衰弱表型（FP）和Rockwood衰弱指数（FI）进行操作化定义。有序逻辑回归分析MetS与现患衰弱状态之间的横断面关联。排除现患衰弱前期或衰弱的个体，采用有序逻辑回归模型分析MetS与新发衰弱之间的关联。最后，研究MetS与Fried衰弱表型五个个体成分之间的纵向关联。模型对年龄、性别、教育程度、吸烟、慢性病病史和肾功能进行了校正。
有序逻辑回归模型（n>5100）显示，MetS与现患衰弱相关，通过FP评估（优势比[OR] 1.29，p<0.001）和FI评估（OR 1.65，p<0.001）均是如此。在基线时非衰弱的个体中，2247名参与者有纵向FP数据，3546名参与者有纵向FI数据。模型表明，MetS与新发衰弱的可能性增加相关，FP评估（OR 1.57，p<0.001）和FI评估（OR 1.29，p = 0.014）均是如此。发现MetS与新发低体力活动（OR 1.57，p = 0.001）和新发非故意体重减轻（OR 1.59，p = 0.025）相关。
在≥50岁的人群中，发现MetS与4年内新发衰弱的可能性增加相关，通过FP测量时增加57%，通过FI测量时增加29%。鉴于衰弱的动态性质以及MetS具有潜在可改变性，MetS应被视为衰弱的一个危险因素，并应在任何全面的老年评估中予以考虑。
