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衰弱与心血管代谢疾病的变化：来自纵向队列研究和基因分析的证据

Changes in Frailty and Cardiometabolic Disease: Evidence From a Longitudinal Cohort Study and Genetic Analysis.

作者信息

Wang Wenjie, Wang Kexin, Chen Guangyuan, Niu Jialong, Liu Yixuan, Wang Zhongke, Ge Hailong

机构信息

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

The First Hospital of Harbin, Harbin, Heilongjiang, China.

出版信息

JACC Adv. 2025 Jun;4(6 Pt 2):101782. doi: 10.1016/j.jacadv.2025.101782.

DOI:10.1016/j.jacadv.2025.101782
PMID:40579064
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12277634/
Abstract

BACKGROUND

Cardiometabolic diseases (CMD) include coronary heart disease, stroke, and diabetes. Patients who have ≥2 CMD are defined as cardiometabolic multimorbidity (CMM). CMD and CMM have been associated with frailty, but studies are limited.

OBJECTIVES

The aim of this study was to examine the association between frailty index (FI), changes in frailty, and risks of CMD and CMM.

METHODS

Data were obtained from the China Health and Retirement Longitudinal Study. Frailty status was classified into 3 categories: robust (FI ≤0.1), pre-frail (FI 0.1-0.25), and frail (FI ≥0.25). Total FI and change in FI (ΔFI) were divided into 3 tertiles. Mendelian randomization was used to clarify the relationship between FI and CMD from a genetic perspective.

RESULTS

A total of 10,022 patients were included (female: 54.0%, median age: 57 years). Robust subjects who progressed to pre-frail/frail status had significantly increased risks of CMD (HR: 1.67, 95% CI: 1.46-1.92) and CMM (HR: 1.80, 95% CI: 1.30-2.50). Participants in the tertile 2 (HR: 1.48, 95% CI: 1.31-1.66) and tertile 3 of the total FI group (HR: 2.11, 95% CI: 1.87-2.37) had increased risks of developing CMD, compared with tertile 1. Participants in the upper tertile of the ΔFI group had higher risks of CMD (HR: 1.61, 95% CI: 1.44-1.80) and CMM (HR: 2.07, 95% CI: 1.61-2.66) than those in the first tertile.

CONCLUSIONS

Progression of frailty status elevates CMD and CMM risks. Higher total FI and ΔFI were also related to increased risks of CMD and CMM.

摘要

背景

心脏代谢疾病（CMD）包括冠心病、中风和糖尿病。患有≥2种CMD的患者被定义为心脏代谢共病（CMM）。CMD和CMM与衰弱有关，但相关研究有限。

目的

本研究旨在探讨衰弱指数（FI）、衰弱变化与CMD和CMM风险之间的关联。

方法

数据来自中国健康与养老追踪调查。衰弱状态分为3类：健康（FI≤0.1）、衰弱前期（FI 0.1 - 0.25）和衰弱（FI≥0.25）。总FI和FI变化（ΔFI）分为3个三分位数。采用孟德尔随机化从基因角度阐明FI与CMD之间的关系。

结果

共纳入10,022例患者（女性：54.0%，中位年龄：57岁）。进展为衰弱前期/衰弱状态的健康受试者患CMD（HR：1.67，95%CI：1.46 - 1.92）和CMM（HR：1.80，95%CI：1.3

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa46/12277634/96de5ff6a20b/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa46/12277634/96de5ff6a20b/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa46/12277634/81838ab6dcec/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa46/12277634/a173c7c4a837/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa46/12277634/525c753aa895/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa46/12277634/28de6c414c89/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa46/12277634/96de5ff6a20b/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa46/12277634/96de5ff6a20b/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa46/12277634/81838ab6dcec/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa46/12277634/a173c7c4a837/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa46/12277634/525c753aa895/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa46/12277634/28de6c414c89/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa46/12277634/96de5ff6a20b/gr5.jpg

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