ArticleDiabetology & metabolic syndrome2025
Longitudinal changes in frailty, insulin resistance and incident cardiovascular-kidney- metabolic syndrome progression in middle-aged and older adults: evidence from CHARLS.
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 5 papers.
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Who cites it
5 citing papers in PubMed.
- Associations of the combined C-reactive protein-triglyceride glucose index and frailty index in different dimensions with incident stroke among individuals with stages 0-3 cardiovascular-kidney-metabolic syndrome.Cardiovascular diabetology · 2026Article
- Mitochondrial Dysfunction at the Intersection of CKM Syndrome: Molecular Mechanisms and Path-to-Target Therapies.International journal of molecular sciences · 2026Review
- Cardiovascular-kidney-metabolic syndrome: a comprehensive review of pathophysiology, epidemiology, diagnosis, and management.Cardiovascular diabetology · 2026Review
- Frailty and Cardiometabolic Outcomes: A Narrative Review.Journal of clinical medicine · 2026Review
- Frailty for cardiovascular risk stratification in CKM syndrome stages 0-3: a UK Biobank prospective cohort study.Frontiers in cardiovascular medicine · 2026Article
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12 authors.
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Abstract
backgroundAlthough frailty has been associated with individual components of cardiovascular-kidney-metabolic (CKM) syndrome, the overall relationship between frailty and CKM syndrome, as well as the potential mediating role of insulin resistance (IR), remains inadequately understood.
methodsWe analyzed data from 4,615 adults aged ≥ 45 years who participated in the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2025. Frailty status was evaluated using the Frailty Index (FI) and classified into three categories: robust, prefrail, and frail. Changes in frailty over time were measured based on frailty status at baseline and during a follow-up survey conducted four years later. Logistic regression, linear regression, and bootstrap analyses were employed to examine the association between frailty and progression to advanced CKM stages, as well as the mediating role of the estimated glucose disposal rate (eGDR) as a proxy for IR.
resultsIndividuals who remained in or progressed to pre-frail or frail states during the study period exhibited significantly increased risks of developing advanced CKM syndrome. In the fully adjusted model, the highest risk of CKM syndrome was observed among individuals who remained consistently pre-frail or frail (OR = 3.80; 95% CI: 2.67-5.46;P < 0.001), followed by those who transitioned from a robust state to a worse frailty category (OR = 3.08; 95% CI: 2.13-4.48;P < 0.001). Furthermore, greater increases in the Frailty Index (ΔFI) and higher overall FI scores were significantly associated with an elevated risk of CKM syndrome (ΔFI: OR = 2.12; 95% CI: 1.51-2.98; FI score: OR = 2.19; 95% CI: 1.54-3.11; P < 0.001), after full adjustment.Mediation analysis indicated that IR accounted for approximately 31.6% of the total effect of frailty on the development of CKM syndrome.
conclusionBoth baseline frailty and its progression over time were independently associated with an elevated risk of advanced CKM syndrome. IR was identified as a partial mediator in this relationship. This finding suggests that IR may serve as a modifiable biological target for intervention.
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