Changes in Frailty and Cardiometabolic Disease

JACC advances Pub Date : 2025-06-01 DOI:10.1016/j.jacadv.2025.101782

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

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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.

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虚弱和心脏代谢疾病的变化

背景心脏代谢疾病（CMD）包括冠心病、中风和糖尿病。具有≥2个CMD的患者被定义为心脏代谢多病（CMM）。CMD和CMM与虚弱有关，但研究有限。目的本研究的目的是检查虚弱指数（FI）、虚弱变化与CMD和CMM风险之间的关系。方法数据来源于中国健康与退休纵向研究。虚弱状态分为3类：健壮（FI≤0.1）、预虚弱（FI 0.1 ~ 0.25）和虚弱（FI≥0.25）。总FI和FI变化（ΔFI）分为3分位数。采用孟德尔随机化方法从遗传学角度阐明FI与CMD之间的关系。结果共纳入10022例患者，其中女性占54.0%，中位年龄57岁。健康受试者进展到体弱/体弱前状态时，患CMD （HR: 1.67, 95% CI: 1.46-1.92）和CMM （HR: 1.80, 95% CI: 1.30-2.50）的风险显著增加。总FI组的第2 tile （HR: 1.48, 95% CI: 1.31-1.66）和第3 tile （HR: 2.11, 95% CI: 1.87-2.37）的参与者与第1 tile相比，患CMD的风险增加。ΔFI组的上五分位数的参与者患CMD （HR: 1.61, 95% CI: 1.44-1.80）和CMM （HR: 2.07, 95% CI: 1.61-2.66）的风险高于第一五分位数的参与者。结论虚弱状态的进展会增加CMD和CMM的风险。较高的总FI和ΔFI也与CMD和CMM的风险增加有关。

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

JACC advances Cardiology and Cardiovascular Medicine

CiteScore

1.90

自引率

0.00%

发文量