Yang Qijiang, Wu Xiaoyun, Duan Jinlan, Chen Yiyin, Yang Tianrui
Department of General Medicine, The First People's Hospital of Zhaoqing, Zhaoqing, Guangdong, China.
Department of Geriatrics, The First People's Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
Front Nutr. 2025 Apr 16;12:1553467. doi: 10.3389/fnut.2025.1553467. eCollection 2025.
Frailty is a prevalent geriatric syndrome marked by diminished physiological reserves and heightened vulnerability to stressors, leading to adverse health outcomes and imposing significant economic burdens on healthcare systems.
This study investigates the relationship between the Dietary Index for Gut Microbiota (DI-GM) and the risk of frailty in middle-aged and older adults, using data from the National Health and Nutrition Examination Survey (NHANES) collected from 2007 to 2018. Weighted logistic regression, subgroup analysis, and restricted cubic splines (RCS) were performed to evaluate the relationship between DI-GM and frailty risk. Additionally, a mediation analysis was conducted to investigate the influence of relevant inflammatory parameters from complete blood count, including leukocyte count, neutrophil count, the neutrophil to lymphocyte ratio (NLR), and the systemic inflammatory response index (SIRI), to elucidate how DI-GM may influence the onset and progression of frailty.
In this cross-sectional analysis of 8,695 participants with a mean age of 65.56 years, 3,173 individuals were classified as frail. After adjusting for all covariates, a significant inverse relationship was observed between DI-GM and the risk of frailty. Quartile analysis revealed that participants in the highest quartile of DI-GM had significantly lower odds of frailty compared to those in the lowest quartile (OR: 0.80, 95% CI: 0.65-0.99, = 0.04). Trend analyses across all models demonstrated a consistent inverse relationship between higher DI-GM quartiles and frailty odds ( < 0.0001 for the crude model; = 0.001 for Model 1; = 0.04 for Model 2). Subgroup analyses confirmed the stability of the impact of DI-GM on frailty risk across various subgroups. RCS showed that the risk of frailty decreased linearly with increasing DI-GM levels. Mediation analysis indicated significant effects for leukocyte count, neutrophil count, NLR, and SIRI, with mediation proportions of 5.7, 7.9, 4.4, and 5.5%, respectively (all < 0.001).
The levels of DI-GM are inversely associated with the risk of frailty, with part of this association mediated by inflammatory parameters.
衰弱是一种常见的老年综合征，其特征是生理储备减少，对应激源的易感性增加，导致不良健康后果，并给医疗系统带来重大经济负担。
本研究利用2007年至2018年美国国家健康与营养检查调查（NHANES）的数据，调查肠道微生物群饮食指数（DI-GM）与中老年人衰弱风险之间的关系。进行加权逻辑回归、亚组分析和受限立方样条（RCS）分析，以评估DI-GM与衰弱风险之间的关系。此外，进行中介分析，以研究全血细胞计数中相关炎症参数的影响，包括白细胞计数、中性粒细胞计数、中性粒细胞与淋巴细胞比值（NLR）和全身炎症反应指数（SIRI），以阐明DI-GM可能如何影响衰弱的发生和发展。
在这项对8695名平均年龄为65.56岁的参与者的横断面分析中，3173人被归类为衰弱。在调整所有协变量后，观察到DI-GM与衰弱风险之间存在显著的负相关。四分位数分析显示，DI-GM最高四分位数的参与者与最低四分位数的参与者相比，衰弱几率显著降低（OR：0.80，95%CI：0.65-0.99，P=0.04）。所有模型的趋势分析表明，较高的DI-GM四分位数与衰弱几率之间存在一致的负相关（粗模型P<0.0001；模型1 P=0.001；模型2 P=0.04）。亚组分析证实了DI-GM对不同亚组衰弱风险影响的稳定性。RCS显示，衰弱风险随DI-GM水平的升高呈线性下降。中介分析表明白细胞计数、中性粒细胞计数、NLR和SIRI有显著影响，中介比例分别为5.7%、7.9%、4.4%和5.5%（均P<0.001）。
DI-GM水平与衰弱风险呈负相关，这种关联部分由炎症参数介导。
