Multidimensional assessment of the cholesterol-HDL-glucose index identifies elevated risk of incident frailty in middle-aged and older adults: longitudinal evidence from CHARLS and ELSA
Main finding · Incident frailty, per higher baseline CHG (CHARLS)Result — go to the resultHazard ratio 1.32 95% CI 1.17–1.49Authors' conclusion
Higher CHG across multiple temporal dimensions was consistently associated with incident frailty in both cohorts. Multidimensional CHG assessment may provide an accessible metabolic risk signal to inform frailty assessment and preventive management.
Study context
- Population
- Middle-aged and older adults in CHARLS and ELSAbaseline analyses per cohort, longitudinal analyses included 3,686 (CHARLS) and 1,327 (ELSA) participants with repeated cholesterol-HDL-glucose (CHG) measurements · CHARLS baseline analyses 6,173 · ELSA baseline analyses 2,736 · CHARLS longitudinal analyses 3,686 · ELSA longitudinal analyses 1,327
- Exposure
- Baseline CHG, cumulative CHG, and change patterns in relation to incident frailty
- Outcome
- Incident frailty, per higher baseline CHG (CHARLS)
Methodological detailsCox regression, restricted cubic splines, K-means clustering
- Cox regression
- Restricted cubic splines
- K-means clustering
Main finding
As reported in the abstract
Hazard ratio
1.32
95% CI 1.17–1.49
Higher baseline CHG
HR 1.32 (95% CI 1.17–1.49)
Per higher baseline CHG, as printed
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Incident frailty, per higher baseline CHG (ELSA)ELSA | 1.56 (1.19–2.05) | |
| Incident frailty, per cumulative CHGCumulative CHG · CHARLS | 1.11 (1.04–1.18) | |
| Incident frailty, per cumulative CHGCumulative CHG · ELSA | 1.19 (1.06–1.35) | |
| Incident frailty by CHG change patternHigh CHG change patternvs Low CHG change patternCHARLS | 1.48 (1.18–1.87) | |
| Incident frailty by CHG change patternHigh CHG change patternvs Low CHG change patternELSA | 1.46 (1.04–2.05) | |
| 0.512Hazard ratio (log scale) |
Shape of associations
- Associations were generally linear
Original publication
Multidimensional assessment of the cholesterol-HDL-glucose index identifies elevated risk of incident frailty in middle-aged and older adults: longitudinal evidence from CHARLS and ELSA. Diabetes Res Clin Pract. Published 11 November 2026. doi:10.
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