Association between non-insulin-based insulin resistance indicators and frailty progression: a national cohort study and mendelian randomization analysis
Authors' conclusion
The non-insulin-based IR indicators, including TyG index, METS-IR and eGDR, were independently associated with the frailty progression and physical function decline. Monitoring and managing abnormal glucose metabolism should be recommended as a part of comprehensive strategies to prevent or delay the progression of frailty.
Study context
- Population
- Participants in the China Health and Retirement Longitudinal Study (CHARLS); frailty index over nine years
- Participants
- 6,722 participants
- Exposure
- Non-insulin-based insulin resistance (IR) indicators (triglyceride-glucose (TyG) index, metabolic score for insulin resistance (METS-IR), estimated glucose disposal rate (eGDR)) and frailty trajectories, frailty risk and physical function decline
- Outcome
- Long-term deficit-accumulation frailty trajectories and physical function decline
- Follow-up
- Nine years
Methodological detailsnational cohort, CHARLS, group-based trajectory model, logistic regression, restricted cubic splines, linear mixed-effects model, adjusted for age, gender, education, marital status, smoking, drinking, life satisfaction, social activity, sleep duration
- National cohort
- CHARLS
- Group-based trajectory model
- Logistic regression
- Restricted cubic splines
- Linear mixed-effects model
- Adjusted for age, gender, education, marital status, smoking, drinking, life satisfaction, social activity, sleep duration
Main finding
As reported in the abstract
Odds ratio (95% CI)
TyG index, per SD incrementfrailty risk; 16.1% increase
1.161(1.092–1.235)
eGDRfrailty risk; inverse association
0.741(0.696–0.788)
Per SD increment, as printed
- TyG index, per SD increment · greater frailty index (FI) increase
- β 0.005 SD/y (95% CI 0.002–0.008); P < 0.001
- METS-IR highest quartile · greater FI progression
- β 0.013 (95% CI 0.004–0.022)
- eGDR, per SD increment · slower FI increase
- β −0.006 SD/y (95% CI −0.009 to −0.003); P < 0.001
- eGDR highest quartile vs eGDR quartile 1 · lower annual change in FI
- β −0.013 SD/y (95% CI −0.022 to −0.005); P for trend = 0.001
- Linear relationship between baseline TyG index and frailty risk
- P nonlinear = 0.696
- Nonlinear association for eGDR
- P nonlinearity < 0.010
- Nonlinear association for METS-IR
- P nonlinearity < 0.010
Observational data: associations, not effects.
Further findings
| Outcome | β (95% CI) | P value |
|---|---|---|
| MR: higher TyG index and frailty riskCausal relationship | 0.214 (0.079–0.349) | P = 0.002 |
Physical function decline
- Similar findings were observed for physical function decline
Original publication
Association between non-insulin-based insulin resistance indicators and frailty progression: a national cohort study and mendelian randomization analysis. Cardiovasc Diabetol. Published 22 January 2025. doi:10.
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