Metabolic syndrome and insulin resistance are associated with frailty in older adults: a prospective cohort study
Metabolic syndrome and insulin resistance are associated with frailty in older adults: a prospective cohort study
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DOI：
10.1093/ageing/afx023
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发表时间：
2017-09-01
期刊：
影响因子：
6.7
通讯作者：
Guallar-Castillon, Pilar
中科院分区：
文献类型：
--
作者：
Perez-Tasigchana, Raul F.;Leon-Munoz, Luz M.;Guallar-Castillon, Pilar
背景：糖尿病增加了虚弱的风险，这是老年人残疾和过早死亡的主要原因。代谢综合征（MS）和胰岛素抵抗（IR）是糖尿病的重要危险因素，因此可能导致虚弱。然而，MS或IR和frailty.Methods之间的关联几乎没有调查：数据来自一个队列的1,499名年龄≥ 60岁的社区居民，他们在2008-10年没有糖尿病，并随访了3.5年。在基线时，根据协调定义确定MS，并使用IR指数的均匀模型评估（HOMA-IR）确定IR。虚弱被定义为有三个或三个以上的弗里德的标准：疲惫，低体力活动，缓慢行走，无意的体重减轻和低握力。结果：2012年，共发现84例偶发性虚弱病例。与非MS受试者相比，MS受试者的虚弱风险增加（多变量比值比[OR]：1.85; 95%置信区间[CI]：1.12-3.05）。在进一步调整纤维蛋白原和C反应蛋白后，这种关联仍然存在。当单独考虑虚弱标准时，低握力是显示与MS更强关联的标准（OR：1.67; 95%CI：1.25-2.21）。结论：MS和IR与体弱风险增加有关。这项工作扩展了MS有害后果的范围，并表明预防或控制MS可能有助于延迟虚弱。
Background: diabetes increases the risk of frailty that is a leading cause of disability and premature mortality in older people. Metabolic syndrome (MS) and insulin resistance (IR) are strong risk factors for diabetes and could, thus, lead to frailty. However, the association between MS or IR and frailty has barely been investigated.Methods: data were obtained from a cohort of 1,499 community-dwelling individuals aged >= 60, who were free of diabetes at 2008-10 and were followed up for 3.5 years. At baseline, MS was ascertained according to the harmonised definition, and IR with the Homoeostatic Model Assessment for IR index (HOMA-IR). Frailty was defined as having three or more of the Fried's criteria: exhaustion, low physical activity, slow walking, unintentional weight loss and low grip strength. Statistical analyses were performed with logistic regression, and adjusted for the main confounders.Results: in 2012, 84 cases of incident frailty were identified. Compared with subjects without MS, those with MS showed increased risk of frailty (multivariate odds ratio [OR]: 1.85; 95% confidence interval [CI] 1.12-3.05). The association persisted after further adjustment for fibrinogen and C-reactive protein. When the frailty criteria were considered individually, low grip strength was the criterion that showed a stronger association with MS (OR: 1.67; 95% CI: 1.25-2.21). Higher HOMA-IR values were also associated with higher risk of frailty.Conclusion: MS and IR were associated with increased risk of frailty. This work extends the spectrum of harmful consequences of MS, and suggests that preventing or controlling MS may serve to delay frailty.