Relationship between changes in the triglyceride glucose-body mass index and frail development trajectory and incidence in middle-aged and elderly individuals: a national cohort study.
Cardiovasc Diabetol
; 23(1): 304, 2024 Aug 16.
Article
em En
| MEDLINE
| ID: mdl-39152445
ABSTRACT
BACKGROUND:
Insulin resistance is linked to an increased risk of frailty, yet the comprehensive relationship between the triglyceride glucose-body mass index (TyG-BMI), which reflects weight, and frailty, remains unclear. This relationship is investigated in this study.METHODS:
Data from 9135 participants in the China Health and Retirement Longitudinal Study (2011-2020) were analysed. Baseline TyG-BMI, changes in the TyG-BMI and cumulative TyG-BMI between baseline and 2015, along with the frailty index (FI) over nine years, were calculated. Participants were grouped into different categories based on TyG-BMI changes using K-means clustering. FI trajectories were assessed using a group-based trajectory model. Logistic and Cox regression models were used to analyse the associations between the TyG-BMI and FI trajectory and frail incidence. Nonlinear relationships were explored using restricted cubic splines, and a linear mixed-effects model was used to evaluate FI development speed. Weighted quantile regression was used to identify the primary contributing factors.RESULTS:
Four classes of changes in the TyG-BMI and two FI trajectories were identified. Individuals in the third (OR = 1.25, 95% CI 1.10-1.42) and fourth (OR = 1.83, 95% CI 1.61-2.09) quartiles of baseline TyG-BMI, those with consistently second to highest (OR = 1.49, 95% CI 1.32-1.70) and the highest (OR = 2.17, 95% CI 1.84-2.56) TyG-BMI changes, and those in the third (OR = 1.20, 95% CI 1.05-1.36) and fourth (OR = 1.94, 95% CI 1.70-2.22) quartiles of the cumulative TyG-BMI had greater odds of experiencing a rapid FI trajectory. Higher frail risk was noted in those in the fourth quartile of baseline TyG-BMI (HR = 1.42, 95% CI 1.28-1.58), with consistently second to highest (HR = 1.23, 95% CI 1.12-1.34) and the highest TyG-BMI changes (HR = 1.58, 95% CI 1.42-1.77), and those in the third (HR = 1.10, 95% CI 1.00-1.21) and fourth quartile of cumulative TyG-BMI (HR = 1.46, 95% CI 1.33-1.60). Participants with persistently second-lowest to the highest TyG-BMI changes (ß = 0.15, 0.38 and 0.76 respectively) and those experiencing the third to fourth cumulative TyG-BMI (ß = 0.25 and 0.56, respectively) demonstrated accelerated FI progression. A U-shaped association was observed between TyG-BMI levels and both rapid FI trajectory and higher frail risk, with BMI being the primary factor.CONCLUSION:
A higher TyG-BMI is associated with the rapid development of FI trajectory and a greater frail risk. However, excessively low TyG-BMI levels also appear to contribute to frail development. Maintaining a healthy TyG-BMI, especially a healthy BMI, may help prevent or delay the frail onset.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Triglicerídeos
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Glicemia
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Biomarcadores
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Índice de Massa Corporal
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Avaliação Geriátrica
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Idoso Fragilizado
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Fragilidade
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article