Gu Yingzhen, Han Xiaorong, Liu Jinxing, Li Yifan, Zhang Wei, Lv Naqiang, Dang Aimin
Fuwai Hospital, National Center for Cardiovascular Diseases, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100037, China.
Fuwai Hospital, National Center for Cardiovascular Diseases, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100037, China.
Nutr Metab Cardiovasc Dis. 2025 Oct;35(10):104114. doi: 10.1016/j.numecd.2025.104114. Epub 2025 May 8.
The relationship between baseline frailty status, changes in frailty status, and the risk of diabetes onset among older adults remains unclear.
This study used data from the China Health and Retirement Longitudinal Study, a prospective and nationally representative cohort. Baseline frailty status was measured by the frailty index (FI) and classified as robust, pre-frail, or frail. Changes in frailty status were assessed by the transitions between non-frailty and frailty at baseline and the second survey within 2-year interval. A total of 11,044 participants were included in the baseline analysis (57.61 years, 49.5 % men), and 7005 participants (56.81 years; 50.3 % men) were included in the analysis of changes in frailty status. Compared with the robust group, the hazard ratio (HR) for diabetes was 1.40 [95 % confidence interval (CI) 1.19-1.64] for the pre-frail group and 2.07 (95 % CI 1.67-2.57) for the frail group. Each 0.1 increase in FI was independently associated with a 30 % higher risk of diabetes. Compared to the stable non-frail group, participants who progressed to frail status had an elevated risk of diabetes (HR 1.72, 95 % CI 1.26-2.35). Conversely, participants who recovered to non-frail status had a decreased risk of diabetes compared to those in the stable frail group (HR 0.46, 95 % CI 0.25-0.83).
Pre-frail and frail participants showed elevated risks of diabetes among middle-aged and older adults. Progression of frailty status correlated with increased diabetes risk, while recovery of frailty status was associated with reduced risk.
老年人的基线衰弱状态、衰弱状态变化与糖尿病发病风险之间的关系尚不清楚。
本研究使用了中国健康与养老追踪调查的数据，这是一个具有全国代表性的前瞻性队列。基线衰弱状态通过衰弱指数（FI）进行测量，并分为健康、衰弱前期或衰弱。衰弱状态的变化通过基线和两年间隔内第二次调查时非衰弱和衰弱之间的转变来评估。共有11044名参与者纳入基线分析（年龄57.61岁，男性占49.5%），7005名参与者（年龄56.81岁；男性占50.3%）纳入衰弱状态变化分析。与健康组相比，衰弱前期组糖尿病的风险比（HR）为1.40 [95%置信区间（CI）1.19 - 1.64]，衰弱组为2.07（95% CI 1.67 - 2.57）。FI每增加0.1与糖尿病风险独立增加30%相关。与稳定的非衰弱组相比，进展为衰弱状态的参与者患糖尿病的风险升高（HR 1.72，95% CI 1.26 - 2.35）。相反，与稳定的衰弱组相比，恢复到非衰弱状态的参与者患糖尿病的风险降低（HR 0.46，95% CI 0.25 - 0.83）。
衰弱前期和衰弱的参与者在中老年人群中患糖尿病的风险升高。衰弱状态的进展与糖尿病风险增加相关，而衰弱状态的恢复与风险降低相关。
