Cardiometabolic disease among frailty phenotype clusters in adults aging with HIV.

IF 3.3 Q2 GERIATRICS & GERONTOLOGY

Journal of Frailty & Aging Pub Date : 2025-04-01 Epub Date: 2025-03-08 DOI:10.1016/j.tjfa.2025.100011

Raymond Jones, Ene M Enogela, Stephanie A Ruderman, Mari M Kitahata, Richard Moore, Jeffrey M Jacobson, Maile Karris, Meredith Greene, Julia Fleming, Sonia Napravnik, Greer Burkholder, Joseph A C Delaney, Heidi M Crane, Amanda L Willig, Thomas W Buford

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引用次数: 0

Abstract

Background: Age-related morbidity, including frailty and cardiometabolic disease has become increasingly prevalent among people living with HIV (PWH), and each frailty characteristic may, independently and synergistically, play a role in cardiometabolic disease.

Objective: To evaluate the prevalence of unique frailty clusters and the prevalence ratios of cardiometabolic diseases within frailty clusters among a large diverse cohort of PWH in clinical care.

Design: Cross-sectional analyses within longitudinal clinical cohort.

Setting: The Center for AIDS Research Network of Integrated Clinical Systems (CNICS) from 8 Clinics PARTICIPANTS: 4,856 PWH, mean age 61 years. 16 % frail, 45 % pre-frail, 40 % robust.

Measurements: The validated, modified Fried Phenotype from patient-reported outcomes and clustering (15 clusters) of the frailty characteristics and cardiometabolic diseases (7 diseases and multimorbidity) within each cluster.

Results: Among 4856 PWH (age: 61 ± 6 years), the prevalence of frail, pre-frail, and robust was 16 %, 45 %, and 40 %, respectively. The most prevalent cardiometabolic disease among frail PWH was hypertension (62.6 %), followed by dyslipidemia (58.8 %) and diabetes (31.4 %). Among pre-frail PWH, the most prevalent cardiometabolic diseases were dyslipidemia (65.8 %), hypertension (61.8 %), and obesity (30.5 %). The prevalence of cardiometabolic disease among frailty clusters varied. For example, PWH in the "fatigue + poor mobility" cluster had a greater prevalence of cerebrovascular disease (PR: 2.23; 95 % CI: 1.01-4.91), diabetes (1.76; 95 % CI: 1.41-2.21), and obesity (1.66; 95 % CI: 1.35-2.05) when compared with robust PWH. Individuals in the "poor mobility" cluster had a higher prevalence of diabetes (1.37; 95 % CI: 1.15-1.64), hypertension (1.12; 95 % CI: 1.04 - 1.22), and obesity (1.38; 95 % CI: 1.17-1.61) compared with robust PWH.

Conclusions: The frailty components, independently and synergistically, were associated with an increased prevalence of cardiometabolic disease. This study identified distinct frailty clusters that may be associated with increased prevalence of cardiometabolic disease among PWH.

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成年HIV感染者脆弱表型群中的心脏代谢疾病

背景：年龄相关的发病率，包括虚弱和心脏代谢疾病在HIV感染者（PWH）中越来越普遍，每一种虚弱特征都可能单独或协同地在心脏代谢疾病中发挥作用。目的：评估临床护理中大量不同的PWH队列中独特虚弱群的患病率和虚弱群中心脏代谢疾病的患病率。设计：纵向临床队列的横断面分析。背景：来自8个诊所的艾滋病综合临床系统研究网络中心（CNICS）参与者：4856名PWH，平均年龄61岁。16%虚弱，45%虚弱前期，40%健壮。测量：从患者报告的结果和每组内的虚弱特征和心脏代谢疾病（7种疾病和多病）的聚类（15个聚类）中验证，修改的Fried表型。结果：4856例PWH（年龄：61±6岁）中，体弱、体弱前期和健壮的患病率分别为16%、45%和40%。在虚弱的PWH中最常见的心脏代谢疾病是高血压（62.6%），其次是血脂异常（58.8%）和糖尿病（31.4%）。在虚弱前PWH中，最常见的心脏代谢疾病是血脂异常（65.8%）、高血压（61.8%）和肥胖（30.5%）。在虚弱人群中，心脏代谢疾病的患病率各不相同。例如，“疲劳+活动能力差”集群的PWH脑血管疾病患病率更高(PR: 2.23；95% CI: 1.01-4.91)，糖尿病(1.76；95% CI: 1.41-2.21)和肥胖(1.66；95% CI: 1.35-2.05)，与稳健PWH相比。“流动性差”群体的个体糖尿病患病率较高(1.37；95% CI: 1.15-1.64)，高血压(1.12；95% CI: 1.04 - 1.22)和肥胖(1.38；95% CI: 1.17-1.61)与稳健PWH相比。结论：这些脆弱因素，无论是独立的还是协同的，都与心脏代谢疾病的患病率增加有关。本研究确定了不同的脆弱集群，可能与PWH中心脏代谢疾病的患病率增加有关。

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

Journal of Frailty & Aging GERIATRICS & GERONTOLOGY-

CiteScore

5.90

自引率

7.70%

发文量

期刊介绍： The Journal of Frailty & Aging is a peer-reviewed international journal aimed at presenting articles that are related to research in the area of aging and age-related (sub)clinical conditions. In particular, the journal publishes high-quality papers describing and discussing social, biological, and clinical features underlying the onset and development of frailty in older persons. The Journal of Frailty & Aging is composed by five different sections: - Biology of frailty and aging In this section, the journal presents reports from preclinical studies and experiences focused at identifying, describing, and understanding the subclinical pathophysiological mechanisms at the basis of frailty and aging. - Physical frailty and age-related body composition modifications Studies exploring the physical and functional components of frailty are contained in this section. Moreover, since body composition plays a major role in determining physical frailty and, at the same time, represents the most evident feature of the aging process, special attention is given to studies focused on sarcopenia and obesity at older age. - Neurosciences of frailty and aging The section presents results from studies exploring the cognitive and neurological aspects of frailty and age-related conditions. In particular, papers on neurodegenerative conditions of advanced age are welcomed. - Frailty and aging in clinical practice and public health This journal’s section is devoted at presenting studies on clinical issues of frailty and age-related conditions. This multidisciplinary section particularly welcomes reports from clinicians coming from different backgrounds and specialties dealing with the heterogeneous clinical manifestations of advanced age. Moreover, this part of the journal also contains reports on frailty- and age-related social and public health issues. - Clinical trials and therapeutics This final section contains all the manuscripts presenting data on (pharmacological and non-pharmacological) interventions aimed at preventing, delaying, or treating frailty and age-related conditions.The Journal of Frailty & Aging is a quarterly publication of original papers, review articles, case reports, controversies, letters to the Editor, and book reviews. Manuscripts will be evaluated by the editorial staff and, if suitable, by expert reviewers assigned by the editors. The journal particularly welcomes papers by researchers from different backgrounds and specialities who may want to share their views and experiences on the common themes of frailty and aging.The abstracting and indexing of the Journal of Frailty & Aging is covered by MEDLINE (approval by the National Library of Medicine in February 2016).