TY - JOUR
T1 - Relationship between changes in the triglyceride glucose-body mass index and frail development trajectory and incidence in middle-aged and elderly individuals
T2 - a national cohort study
AU - Guo, Kai
AU - Wang, Qi
AU - Zhang, Lin
AU - Qiao, Rui
AU - Huo, Yujia
AU - Jing, Lipeng
AU - Wang, Xiaowan
AU - Song, Zixuan
AU - Li, Siyu
AU - Zhang, Jinming
AU - Yang, Yanfang
AU - Mahe, Jinli
AU - Liu, Zhengran
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/12
Y1 - 2024/12
N2 - Background: Insulin resistance is linked to an increased risk of frailty, yet the comprehensive relationship between the triglyceride glucose-body mass index (TyG-BMI), which reflects weight, and frailty, remains unclear. This relationship is investigated in this study. Methods: Data from 9135 participants in the China Health and Retirement Longitudinal Study (2011–2020) were analysed. Baseline TyG-BMI, changes in the TyG-BMI and cumulative TyG-BMI between baseline and 2015, along with the frailty index (FI) over nine years, were calculated. Participants were grouped into different categories based on TyG-BMI changes using K-means clustering. FI trajectories were assessed using a group-based trajectory model. Logistic and Cox regression models were used to analyse the associations between the TyG-BMI and FI trajectory and frail incidence. Nonlinear relationships were explored using restricted cubic splines, and a linear mixed-effects model was used to evaluate FI development speed. Weighted quantile regression was used to identify the primary contributing factors. Results: Four classes of changes in the TyG-BMI and two FI trajectories were identified. Individuals in the third (OR = 1.25, 95% CI: 1.10–1.42) and fourth (OR = 1.83, 95% CI: 1.61–2.09) quartiles of baseline TyG-BMI, those with consistently second to highest (OR = 1.49, 95% CI: 1.32–1.70) and the highest (OR = 2.17, 95% CI: 1.84–2.56) TyG-BMI changes, and those in the third (OR = 1.20, 95% CI: 1.05–1.36) and fourth (OR = 1.94, 95% CI: 1.70–2.22) quartiles of the cumulative TyG-BMI had greater odds of experiencing a rapid FI trajectory. Higher frail risk was noted in those in the fourth quartile of baseline TyG-BMI (HR = 1.42, 95% CI: 1.28–1.58), with consistently second to highest (HR = 1.23, 95% CI: 1.12–1.34) and the highest TyG-BMI changes (HR = 1.58, 95% CI: 1.42–1.77), and those in the third (HR = 1.10, 95% CI: 1.00-1.21) and fourth quartile of cumulative TyG-BMI (HR = 1.46, 95% CI: 1.33–1.60). Participants with persistently second-lowest to the highest TyG-BMI changes (β = 0.15, 0.38 and 0.76 respectively) and those experiencing the third to fourth cumulative TyG-BMI (β = 0.25 and 0.56, respectively) demonstrated accelerated FI progression. A U-shaped association was observed between TyG-BMI levels and both rapid FI trajectory and higher frail risk, with BMI being the primary factor. Conclusion: A higher TyG-BMI is associated with the rapid development of FI trajectory and a greater frail risk. However, excessively low TyG-BMI levels also appear to contribute to frail development. Maintaining a healthy TyG-BMI, especially a healthy BMI, may help prevent or delay the frail onset.
AB - Background: Insulin resistance is linked to an increased risk of frailty, yet the comprehensive relationship between the triglyceride glucose-body mass index (TyG-BMI), which reflects weight, and frailty, remains unclear. This relationship is investigated in this study. Methods: Data from 9135 participants in the China Health and Retirement Longitudinal Study (2011–2020) were analysed. Baseline TyG-BMI, changes in the TyG-BMI and cumulative TyG-BMI between baseline and 2015, along with the frailty index (FI) over nine years, were calculated. Participants were grouped into different categories based on TyG-BMI changes using K-means clustering. FI trajectories were assessed using a group-based trajectory model. Logistic and Cox regression models were used to analyse the associations between the TyG-BMI and FI trajectory and frail incidence. Nonlinear relationships were explored using restricted cubic splines, and a linear mixed-effects model was used to evaluate FI development speed. Weighted quantile regression was used to identify the primary contributing factors. Results: Four classes of changes in the TyG-BMI and two FI trajectories were identified. Individuals in the third (OR = 1.25, 95% CI: 1.10–1.42) and fourth (OR = 1.83, 95% CI: 1.61–2.09) quartiles of baseline TyG-BMI, those with consistently second to highest (OR = 1.49, 95% CI: 1.32–1.70) and the highest (OR = 2.17, 95% CI: 1.84–2.56) TyG-BMI changes, and those in the third (OR = 1.20, 95% CI: 1.05–1.36) and fourth (OR = 1.94, 95% CI: 1.70–2.22) quartiles of the cumulative TyG-BMI had greater odds of experiencing a rapid FI trajectory. Higher frail risk was noted in those in the fourth quartile of baseline TyG-BMI (HR = 1.42, 95% CI: 1.28–1.58), with consistently second to highest (HR = 1.23, 95% CI: 1.12–1.34) and the highest TyG-BMI changes (HR = 1.58, 95% CI: 1.42–1.77), and those in the third (HR = 1.10, 95% CI: 1.00-1.21) and fourth quartile of cumulative TyG-BMI (HR = 1.46, 95% CI: 1.33–1.60). Participants with persistently second-lowest to the highest TyG-BMI changes (β = 0.15, 0.38 and 0.76 respectively) and those experiencing the third to fourth cumulative TyG-BMI (β = 0.25 and 0.56, respectively) demonstrated accelerated FI progression. A U-shaped association was observed between TyG-BMI levels and both rapid FI trajectory and higher frail risk, with BMI being the primary factor. Conclusion: A higher TyG-BMI is associated with the rapid development of FI trajectory and a greater frail risk. However, excessively low TyG-BMI levels also appear to contribute to frail development. Maintaining a healthy TyG-BMI, especially a healthy BMI, may help prevent or delay the frail onset.
KW - Cohort study
KW - Frailty index
KW - Group-based trajectory model
KW - K-means clustering
KW - TyG-BMI
UR - http://www.scopus.com/inward/record.url?scp=85201419957&partnerID=8YFLogxK
U2 - 10.1186/s12933-024-02373-1
DO - 10.1186/s12933-024-02373-1
M3 - Article
C2 - 39152445
AN - SCOPUS:85201419957
SN - 1475-2840
VL - 23
JO - Cardiovascular Diabetology
JF - Cardiovascular Diabetology
IS - 1
M1 - 304
ER -