Physical frailty, genetic predisposition, and type 2 diabetes mellitus

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism Pub Date : 2025-02-01 DOI:10.1016/j.diabet.2025.101618

Zhenyi Xu , Ruilang Lin , Xueying Ji , Chen Huang , Ce Wang , Yongfu Yu , Zhijun Bao

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引用次数: 0

Abstract

Aim

To examine the association between frailty and incident type 2 diabetes mellitus (T2DM), considering the joint effect of multimorbidity and genetic risk.

Methods

The study included 429,022 individuals in the UK Biobank. We used Cox regression with hazard ratio (HR) and 95 % confidence interval (CI) to 1) evaluate the associations of frailty with incident T2DM, 2) explore whether frailty and multimorbidity would have a joint effect, and 3) assess whether the associations were modified by genetic risk.

Results

Compared with non-frail individuals, prefrail and frail individuals were at higher risk of T2DM: HR[95 %CI] = 1.42 [1.38;1.47] for prefrailty and 1.81[1.70;1.92] for frailty. Five frailty components were associated with increased risk of T2DM: HR[95 %CI] = 1.21[1.17;1.26] for weight loss, 1.35[1.30;1.40] for exhaustion, 1.31[1.26;1.37] for low physical activity, 1.27[1.20;1.33] for low grip strength, and 1.47[1.41;1.52] for slow gait speed. The increased risks were more pronounced among frail individuals with more than three morbidities: HR[95 %CI] = 4.10[3.76;4.46]. Frail individuals at high genetic risk had a four and a half-fold greater risk of T2DM compared with non-frail individuals at low genetic risk: HR[95 %CI] = 4.54[4.14;4.97].

Conclusion

Frailty was associated with increased risk of T2DM, especially in individuals with higher number of morbidities and high genetic risk. Frailty may be an independent risk factor for T2DM and targeted strategies to prevent and manage frailty would contribute to reducing the risk of T2DM.

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身体虚弱，遗传易感性和2型糖尿病

目的探讨虚弱与2型糖尿病（T2DM）发病之间的关系，同时考虑多种疾病和遗传风险的共同作用。该研究包括英国生物银行的429,022名个体。我们使用带有风险比（HR）和95%置信区间（CI）的Cox回归来1)评估虚弱与T2DM事件的关联，2)探索虚弱和多病是否会有联合效应，以及3)评估这种关联是否被遗传风险所改变。结果与非体弱者相比，体弱者和体弱者发生T2DM的风险更高：体弱者的HR[95% CI] = 1.42[1.38;1.47]，体弱者的HR[95% CI] = 1.81[1.70;1.92]。五种虚弱因素与T2DM风险增加相关：体重减轻的HR[95% CI] = 1.21[1.17;1.26]，疲劳的HR[95% CI] = 1.35[1.30;1.40]，体力活动不足的HR[1.31][1.26;1.37]，握力不足的HR[1.27][1.20;1.33]，步态速度慢的HR[1.41;1.52]。在有三种以上疾病的体弱个体中，风险增加更为明显：HR[95% CI] = 4.10[3.76;4.46]。高遗传风险的体弱个体患T2DM的风险是低遗传风险的非体弱个体的4.5倍：HR[95% CI] = 4.54[4.14;4.97]。结论虚弱与T2DM风险增加有关，特别是在发病率高、遗传风险高的人群中。虚弱可能是2型糖尿病的独立危险因素，有针对性的预防和管理虚弱有助于降低2型糖尿病的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes & metabolism 医学-内分泌学与代谢

CiteScore

12.00

自引率

4.20%

发文量

审稿时长

13 days

期刊介绍： A high quality scientific journal with an international readership Official publication of the SFD, Diabetes & Metabolism, publishes high-quality papers by leading teams, forming a close link between hospital and research units. Diabetes & Metabolism is published in English language and is indexed in all major databases with its impact factor constantly progressing. Diabetes & Metabolism contains original articles, short reports and comprehensive reviews.