Evidence map›Paper›PMID 41233907›Full record

ArticleDiabetology & metabolic syndrome2025

Which insulin resistance indices best predict future frailty progression in a cardiovascular-kidney-metabolic syndrome stage 0-3 population: a national prospective cohort and machine learning study.

Ruikang Liu, Guangyi Yang, Yiying Liu, Jun Li, Botan Xu, Guancheng Ye, Xuanchun Huang, Shiyi Tao, Tiantian Xue, Yonghao Li and 1 more

Abstract read
In one paragraph

Article in Diabetology & metabolic syndrome, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Ruikang Liu *Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Guangyi Yang *Graduate School, Beijing University of Chinese Medicine, Beijing, China.
Yiying Liu *Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Jun LiGuang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China. gamyylj@163.com.
Botan XuWangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Guancheng YeWangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Xuanchun HuangGuang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Shiyi TaoGuang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Tiantian XueGuang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Yonghao LiGuang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Fuyuan ZhangGuang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China. doctorzfy2021@163.com.

Funding

National Key Research and Development Program of China, under the project titled Modernization of Traditional Chinese Medicine: Innovative Pathogenesis of Hypertensive Heart Failure and Its Clinical Diagnosis and Treatment Protocol Research 2022YFC3500102
6 · The paper itself

Abstract

backgroundInsulin resistance (IR) is implicated in frailty progression within Cardiovascular-Kidney-Metabolic (CKM) syndrome populations. While multiple non-insulin-based IR indices have been proposed, their comparative utility in predicting frailty across early CKM stages (0-3) remains unclear. Identifying reliable, non-insulin-based IR indices for predicting frailty index (FI) across early CKM stages (0-3) remains challenging.

methodsThis prospective cohort study analyzed 4,354 adults (≥ 45 years) from the China Health and Retirement Longitudinal Study (2011-2015). We evaluated and compared 12 IR indices for predicting frailty progression. Associations were assessed using multivariable logistic regression. Machine learning (RFE, Boruta, and LASSO) identified optimal predictors, and a Random Forest (RF) model incorporating key covariates was developed and validated.

resultsAfter full adjustment, CTI (OR = 1.19), TyG-WHtR (OR = 1.12), TyG-WC (OR = 1.00), and eGDR (OR = 0.87) significantly predicted FI (all p < 0.05). Among all indices, TyG-WHtR demonstrated the most stable discriminative performance across CKM stages 0-3 (AUCs: 0.52-0.59, all p < 0.001). Machine learning consistently selected TyG-WHtR as the top predictor. The final 13-variable RF model achieved an AUC of 0.74. SHAP analysis confirmed TyG-WHtR, age, depressive symptoms, and renal biomarkers as key predictors.

conclusionTyG-WHtR is a robust, stable predictor of frailty progression in individuals with CKM syndrome stages 0-3. Its integration into clinical practice, potentially via the developed web tool, could enhance early frailty risk stratification.

Indexed as

Cardiovascular-kidney-metabolic syndromeCohort studyFrailtyInsulin resistanceMachine learningTyG-WHtR

Identifiers

PMID41233907
PMCPMC12613633

What Socratic holds

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.