Associations of insulin resistance estimated by glucose disposal rate with frailty progression

Objectives

To investigate the relationship between estimated glucose disposal rates (eGDR) and the progression of frailty, using longitudinal data.

Methods

We analyzed four waves of data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018, involving 6,778 middle-aged and older adults. eGDR was calculated using a specific formula, categorizing participants into high and low eGDR groups based on the lowest quartile (8.5). Frailty status was assessed using the frailty index (FI). Linear mixed-effects models were employed to analyze the association between eGDR and frailty progression, as well as the impact of transitions in eGDR.

Results

We found that the baseline FI was significantly higher in the low eGDR group compared to the high eGDR group. Furthermore, participants in the low eGDR group exhibited a faster progression of frailty, compared to those in the high eGDR group. Among non-frail participants at baseline, the association between low eGDR and accelerated frailty progression was even more pronounced. Further analysis revealed that, compared to participants who maintained a stable high eGDR, those who transitioned from high to low eGDR and those who consistently remained in the low eGDR group both experienced significantly accelerated frailty progression. On the contrary, participants who transitioned from low to high eGDR did not show a significant acceleration in frailty progression compared to those who consistently maintained a high eGDR.

Conclusion

Low eGDR is linked to accelerated frailty progression in middle-aged and older Chinese adults. Transitioning from low to high eGDR may mitigate this progression, highlighting the importance of eGDR in frailty management.