Association between the triglyceride-glucose-frailty index and the risk of diabetes mellitus among middle-aged and elderly population
XIE Jiang1,2, WANG Yufeng2, ZHANG Juan2, SONG Yingnan2, LUO Ling1, TAO Meiyi2, SU Wanying1
1. Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan 410005, China; 2. School of Nursing, Faculty of Medicine, Hunan Normal University, Changsha, Hunan 410013, China
Abstract：Objective To explore the association between the triglyceride-glucose-frailty index and the risk of diabetes mellitus among middle-aged and elderly population, so as to provide the evidence for diabetes mellitus risk screening and management among middle-aged and elderly population. Methods Based on data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018, middle-aged and elderly individuals aged ≥45 years without diabetes mellitus at baseline were selected as study participants. Demographic characteristics, lifestyles, and laboratory test data were collected. The triglyceride-glucose index was calculated using triglyceride and fasting blood glucose levels, and the frailty index was derived from a 29-item health deficit accumulation model. The triglyceride-glucose-frailty index was obtained by multiplying the two indices, and participants were divided into four groups according to quartiles. Association between the triglyceride-glucose-frailty index and diabetes mellitus incidence risk was analyzed using a multivariable Cox proportional hazards regression model, and the dose-response relationship was assessed using a restricted cubic spline model. Results A total of 5 246 participants were included, including 2 364 males (45.06%) and 2 882 females (54.94%). The mean age was (58.38±8.78) years. The median of the triglyceride-glucose-frailty index was 0.78 (interquartile range, 1.13). By 2018, 452 diabetes mellitus cases were identified, with a cumulative incidence of 8.62%. Multivariable Cox proportional hazards regression analysis showed that, after adjusting for demographic characteristics, lifestyle factors, and biochemical indicators, each one-standard-deviation increase of the triglyceride-glucose-frailty index was associated with a 37.5% higher risk of diabetes mellitus incidence (HR=1.375, 95%CI: 1.278-1.479). Compared with the Q1 group, the risk increased by 50.8% (HR=1.508, 95%CI: 1.072-2.123), 91.3% (HR=1.913, 95%CI: 1.380-2.651) and 241.6% (HR=3.416, 95%CI: 2.499-4.671) in the Q2, Q3 and Q4 groups, respectively, presenting an upward trend (Pfor trend <0.05). Restricted cubic spline analysis showed a non-linear relationship between the triglyceride-glucose-frailty index and diabetes mellitus incidence risk (P<0.05). Conclusion The triglyceride-glucose-frailty index was positively associated with diabetes mellitus risk among middle-aged and elderly population, and a nonlinear dose-response relationship was observed between the two.
谢江, 王雨凤, 张娟, 宋英楠, 罗玲, 陶美伊, 苏晚英. 甘油三酯-葡萄糖-衰弱指数与中老年人糖尿病发病风险的关联研究[J]. 预防医学, 2026, 38(6): 573-577,582.
XIE Jiang, WANG Yufeng, ZHANG Juan, SONG Yingnan, LUO Ling, TAO Meiyi, SU Wanying. Association between the triglyceride-glucose-frailty index and the risk of diabetes mellitus among middle-aged and elderly population. Preventive Medicine, 2026, 38(6): 573-577,582.
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