The association between frailty, the metabolic syndrome, and mortality over the lifespan
The association between frailty, the metabolic syndrome, and mortality over the lifespan
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DOI：
10.1007/s11357-017-9967-9
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发表时间：
2017-04-01
期刊：
影响因子：
5.6
通讯作者：
Howlett, Susan E.
中科院分区：
文献类型：
--
作者：
Kane, Alice E.;Gregson, Edward;Howlett, Susan E.
虚弱和代谢综合征都与不良结局相关，但在非常老年人（90岁以上）中，只有虚弱与死亡风险增加相关。我们调查了年轻（20 - 65岁）和老年（65岁以上）人群中虚弱、代谢综合征和死亡风险之间的关系。这是对2003 - 2004年和2005 - 2006年美国国家健康和营养调查（NHANES）数据集的二次分析，与截至2011年的死亡率数据相关联。代谢综合征是使用国际糖尿病联合会标准定义的。使用41项虚弱指数（FI）对虚弱进行操作。与年轻组（n = 6403）相比，老年人（n = 2152）具有更高的FI（0.10 ± 0.00 vs. 0.22 ± 0.00，p <0.001）和更高的代谢综合征患病率（24.1 vs. 45.5%，p <0.001）。代谢综合征与FI在年轻人中相关（r = 0.25，p <0.001），而在老年人中不相关（r = 0.08，p <0.1）。在双变量分析中，FI预测两个年龄组的死亡风险，而代谢综合征仅在年轻组中预测死亡风险。在考克斯模型中，校正了年龄、性别、种族、教育和其他因素，FI与两个年龄段的死亡风险增加相关（年轻HR 1.05（1.04 - 1.06）;老年HR 1.04（1.03 - 1.04），而代谢综合征对死亡风险没有贡献。与年龄无关，FI比代谢综合征更能预测死亡率。
Frailty and the metabolic syndrome are each associated with poor outcomes, but in very old people (90+ years) only frailty was associated with an increased mortality risk. We investigated the relationship between frailty, metabolic syndrome, and mortality risk, in younger (20-65 years) and older (65+ years) people. This is a secondary analysis of the US National Health and Nutrition Examination Survey (NHANES) datasets for 2003-2004 and 2005-2006, linked with mortality data up to 2011. The metabolic syndrome was defined using the International Diabetes Federation criteria. Frailty was operationalized using a 41-item frailty index (FI). Compared to the younger group (n = 6403), older adults (n = 2152) had both a higher FI (0.10 + 0.00 vs. 0.22 +/- 0.00, p < 0.001) and a greater prevalence of the metabolic syndrome (24.1 vs. 45.5%, p < 0.001). The metabolic syndrome and FI were correlated in younger people (r = 0.25, p < 0.001) but not in older people (r = 0.08, p < 0.1). In bivariate analyses, the FI predicted mortality risk in both age groups whereas the metabolic syndrome did so only in the younger group. In Cox models, adjusted for age, sex, race, education, and each other, the FI was associated with increased mortality risk at both ages (younger HR 1.05 (1.04-1.06); older HR 1.04 (1.03-1.04) whereas the metabolic syndrome did not contribute to mortality risk. The FI better predicted mortality than did the metabolic syndrome, regardless of age.