Association of triglyceride-glucose index trajectory and frailty in urban older residents: evidence from the 10-year follow-up in a cohort study

Abstract

Background Frailty is an age-related geriatric syndrome that leads to a series of clinically negative events. A better understanding of the factors associated with frailty assists in preventing its progression. The triglyceride-glucose (TyG) index, a simple alternative index of insulin resistance, has not yet been proven to be associated with frailty. The present study aimed to investigate the association between the TyG index and its trajectory with frailty from a cross-sectional, retrospective and prospective level based on an ongoing cohort. Methods This longitudinal study included 1,866 older residents from the “Fujian prospective aging cohort” (ChiCTR 2,000,032,949). The TyG index was calculated as ln [fasting triglyceride (mg/dL) ╳ fasting plasma glucose (mg/dL)/2] and group-based trajectory model (GBTM) was applied to identify the trajectory of TyG index. The association between different trajectory groups of TyG index with frailty risk were estimated using multinomial logistic regression analysis. Results In the cross-sectional analysis, the highest quartile of the TyG index was associated with an increased risk of frailty (TyG index Q4 vs. Q1, OR = 1.50, 95% CI 1.00–2.25, P = 0.048). Restricted cubic splines demonstrated an increasing trend for TyG index and frailty risk. During a follow-up of ten years, three distinct trajectories of the TyG index were identified: low-stable (n = 697, 38.3%), moderate-stable (n = 910, 50.0%) and high-stable (n = 214, 11.7%). Compared with those in the stable-low group of TyG index trajectory, the ORs (95% CI) of prefrailty and frailty risk were 1.79 (95% CI 1.11–2.88) and 2.17 (95% CI 1.01–3.88) for the high-stable group, respectively (P = 0.017 and P = 0.038). In the subgroup analysis, the association of the high-stable trajectory of TyG and frailty status were only observed in subjects with BMI ≥ 24 kg/m2. Prospectively, the highest quartile of the TyG index was associated with a 2.09-fold significantly increased risk of one-year ADL/IADL decline (P = 0.045). Conclusions The present study suggests a potential role for a high and sustainable level of TyG index in the risk of frailty. The trajectories of the TyG index can help to identify older individuals at a higher risk of frailty who deserve primitive preventive and therapeutic approaches.

Association of the triglyceride-glucose index and its related parameters with frailty

“…The TyG index has been shown to have favorable specificity and sensitivity in the diagnosis and prediction of many diseases, particularly CVD [ 38 – 40 ]. In agreement with our findings, a recent two-way cohort study in China has indicated that an elevated TyG index and steady trajectory of the TyG index are beneficial regarding the development of frailty [ 25 ]. To our knowledge, that study has provided the only exploration of the relationship between the TyG index and frailty, although it is limited to Chinese individuals.…”

“…Obesity induces skeletal muscle immune cell infiltration and the secretion of inflammatory factors from visceral adipose tissue, thereby inducing skeletal muscle inflammation, inhibiting myocyte metabolism, and leading to IR and ultimately multiple adverse outcomes [ 67 ]. A large cohort study has emphasized the importance of overweight or obesity in the relationship between the TyG index and frailty [ 25 ]. A Japanese study has suggested that obesity is beneficial regarding frailty in middle-aged and older adults, and appropriate weight loss can effectively decrease the prevalence of frailty in overweight and obese patients with diabetes [ 32 ].In addition, another cohort study has emphasized that decreasing abdominal obesity is a crucial measure for preventing frailty [ 33 ].…”

“…However, limited studies have examined the relationship between the TyG index and frailty. Recently, a prospective cohort study from China has suggested that an elevated TyG index is a potential risk factor for frailty, particularly in populations with high body mass index (BMI) [ 25 ]. Nevertheless, it is unclear if this conclusion applies to Americans.…”

Triglyceride-glucose index, renal function and cardiovascular disease: a national cohort study

“…The Hanzhong Adolescent Hypertension Cohort study found that elevated levels of the baseline TyG index and a higher long-term trajectory of the TyG index were independently associated with increased arterial stiffness [ 35 ], which was also observed in one of our previous studies [ 9 ]. In addition, the effects of TyG on diabetes, carotid atherosclerosis, hypertension, liver diseases and frailty have also been reported [ 36 – 40 ]. Of note, the TyG index is potentially associated with impaired renal function.…”

Causality between sleep traits and the risk of frailty: a Mendelian randomization study

“…To test the second core hypothesis of MR and to mitigate the effects of variables that may distort UVMR results, MVMR was used to assess the relationship between exposure, confounders, and outcomes. We reviewed the literature to identify common risk factors associated with frailty, including smoking ( 38 ), physical activity ( 39 ), BMI ( 40 ), and triglycerides ( 41 ).…”