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| 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
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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 |
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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.
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Received: 14 January 2026
Revised: 19 May 2026
Published: 22 June 2026
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