Estimated Glucose Disposal Rate Associated With Risk of Frailty and Likelihood of Reversion

IF 9.4 1区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Cachexia Sarcopenia and Muscle Pub Date : 2025-04-17 DOI:10.1002/jcsm.13814

Dingchun Hou, Shangjun Liu, Yumei Sun, Chang Liu, Xue Shang, Lijun Pei, Gong Chen

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引用次数: 0

Abstract

Background

Estimated glucose disposal rate (eGDR) is a simple and effective measure for insulin resistance, which is associated with higher risk of frailty. We aim to analyse the associations of eGDR with frailty risk and its reversibility.

Methods

A population-based longitudinal study was conducted of 11 670 participants from the China Health and Retirement Longitudinal Study and 19 355 participants from the Health and Retirement Study. Frailty was assessed by the frailty index and reversibility was measured by transitions from frailty at baseline to non-frailty during follow-up. The eGDR was divided into Q₁, Q₂, Q₃ and Q₄ according to the quartiles. Multi-state Markov model was performed to evaluate the effects of eGDR on transitions among non-frailty, frailty and death. Cox regression model was used to estimate eGDR associated with the risk of frailty and the likelihood of reversion.

Results

In Chinese population characterized by a median age of 60 years (IQR: 54–66) with 6119 women (52.43%), compared with the Q₁ level of eGDR, participants exposure to Q₃ and Q₄ level decreased the probability of transitioning from non-frailty to frailty by 22% (HR = 0.78, 95% CI: 0.69–0.88) and 25% (HR = 0.75, 95% CI: 0.66–0.86), respectively. But its Q₂, Q₃ and Q₄ levels increased the probability of transitioning from frailty to non-frailty by 24% (HR = 1.24, 95% CI: 1.06–1.44), 39% (HR = 1.39, 95% CI: 1.19–1.64) and 33% (HR = 1.33, 95% CI: 1.13–1.58). In American population with a median age of 63 years (IQR: 56–72) and 11 189 women (57.81%), its Q₂, Q₃ and Q₄ levels decreased the probability of transitioning from non-frailty to frailty by 17% (HR = 0.83, 95% CI: 0.77–0.89), 24% (HR = 0.76, 95% CI: 0.70–0.82) and 46% (HR = 0.54, 95% CI: 0.49–0.59), respectively. The probability of revising frailty increased by 25% (HR = 1.25, 95% CI: 1.13–1.38), 36% (HR = 1.36, 95% CI: 1.22–1.51) and 48% (HR = 1.48, 95% CI: 1.30–1.69) for levels Q₂, Q₃ and Q₄. As shown in the prospective analysis, increased eGDR levels from Q₂ to Q₄ were associated with decreased frailty risk and higher likelihood of reversion, as evidenced by the dose–response relationship revealed by restricted cubic spline analysis.

Conclusions

Higher levels of eGDR were associated with a reduced risk of frailty, delayed transition from non-frailty to frailty and an increased likelihood of reversion. eGDR emerges as a promising predictor for early frailty detection, prognosis assessment and a potential therapeutic target for intervention strategies.

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估计葡萄糖处置率与衰弱风险和逆转可能性相关

背景估计葡萄糖处置率（eGDR）是衡量胰岛素抵抗的一种简单有效的指标，而胰岛素抵抗与机体脆弱的高风险相关。我们的目的是分析eGDR与脆弱风险及其可逆性的关系。方法对来自中国健康与退休纵向研究的11 670名受试者和来自健康与退休研究的19 355名受试者进行基于人群的纵向研究。虚弱程度通过虚弱指数来评估，可逆性通过随访期间从基线虚弱到非虚弱的转变来衡量。eGDR按四分位数分为Q1、Q2、Q3和Q4。采用多状态马尔可夫模型评价eGDR对非脆弱、脆弱和死亡之间过渡的影响。采用Cox回归模型估计eGDR与衰弱风险和回归可能性的相关性。结果在中位年龄为60岁（IQR: 54-66）的中国人群中有6119名女性（52.43%），与eGDR Q1水平相比，暴露于Q3和Q4水平的参与者从非虚弱向虚弱过渡的概率分别降低了22% （HR = 0.78, 95% CI: 0.69-0.88）和25% （HR = 0.75, 95% CI: 0.66-0.86）。但其Q2， Q3和Q4水平增加了从虚弱过渡到非虚弱的可能性，分别为24% (HR = 1.24, 95% CI: 1.06-1.44), 39% （HR = 1.39, 95% CI: 1.19-1.64）和33% （HR = 1.33, 95% CI: 1.13-1.58）。在中位年龄为63岁（IQR: 56-72）和1189名女性（57.81%）的美国人群中，其Q2， Q3和Q4水平分别降低了17% (HR = 0.83, 95% CI: 0.77-0.89), 24% （HR = 0.76, 95% CI: 0.70-0.82）和46% （HR = 0.54, 95% CI: 0.49-0.59）从非虚弱过渡到虚弱的概率。对于Q2、Q3和Q4级别，修正脆弱性的概率分别增加了25% （HR = 1.25, 95% CI: 1.13-1.38）、36% （HR = 1.36, 95% CI: 1.22-1.51）和48% （HR = 1.48, 95% CI: 1.30-1.69）。前瞻性分析显示，从Q2到Q4， eGDR水平的增加与衰弱风险的降低和逆转的可能性增加相关，限制三次样条分析显示的剂量-反应关系证明了这一点。结论：较高水平的eGDR与虚弱风险降低、从非虚弱到虚弱的转变延迟以及恢复的可能性增加有关。eGDR是早期虚弱检测、预后评估和干预策略的潜在治疗靶点的一个有希望的预测因子。

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 Cachexia Sarcopenia and Muscle MEDICINE, GENERAL & INTERNAL-

CiteScore

13.30

自引率

12.40%

发文量

234

审稿时长

16 weeks

期刊介绍： The Journal of Cachexia, Sarcopenia and Muscle is a peer-reviewed international journal dedicated to publishing materials related to cachexia and sarcopenia, as well as body composition and its physiological and pathophysiological changes across the lifespan and in response to various illnesses from all fields of life sciences. The journal aims to provide a reliable resource for professionals interested in related research or involved in the clinical care of affected patients, such as those suffering from AIDS, cancer, chronic heart failure, chronic lung disease, liver cirrhosis, chronic kidney failure, rheumatoid arthritis, or sepsis.