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<p>Evidence on the longitudinal relationship between the triglyceride–glucose (TyG) index and different frailty progression and transition patterns, especially the early onset of frailty, is scarce. Participants aged 45 years and older were enrolled from the nationally representative cohort of China Health and Retirement Longitudinal Study (CHARLS). Frailty status was repeatedly assessed by a deficit-accumulated frailty index (FI) during a 7-year follow-up. Restricted cubic spline, linear mixed model, and Cox regression model were used to examine the associations between frailty progression and transition. In total, 8,510 participants were included. The TyG index was positively associated with FI. Each unit increment in TyG index predicted 0.00126 (95%CI: 0.00068–0.00184, <i>p</i> &lt; 0.0001) increase in FI per year. Compared to maintained stable status, TyG index showed positive associations with worsened transitions to pre-frail (OR: 1.14, 95%CI: 1.02–1.26, <i>p</i> = 0.018) and frail (OR:1.14, 95%CI: 1.03–1.27, <i>p</i> = 0.015) status. In contrast, a lower TyG index was inversely associated with improved frailty transitions among women (OR: 0.76, 95%CI: 0.61–0.94, <i>p</i> = 0.010), with a significant TyG × sex interaction (<i>p</i> = 0.021). A similar inverse trend was observed among adults under 60 years (OR: 0.68, 95%CI: 0.531–0.88, <i>p</i> = 0.003), although the TyG × age group interaction was not statistically significant (<i>p</i> = 0.988). A J-shaped relationship was identified between TyG index and frailty onset, with thresholds of 9.10 for the transition from robust to pre-frail and 9.14 for the transition from robust to frail. Above these thresholds, each unit increase in TyG index was significantly associated with a 35% and a67% higher risk of pre-frail (HR 1.35, 95%CI: 1.11–1.65, <i>p</i> = 0.003) and frail transition (HR 1.67, 95%CI: 1.04–2.68, <i>p</i> = 0.035), respectively. Below these thresholds, the associations were insignificant. The main findings remained largely consistent across various sensitivity analyses. The TyG index may serve as a feasible indicator for screening and monitoring of frailty progression and transition. A TyG index greater than 9.10 may be the optimal threshold for predicting the early onset of frailty.</p>

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Association between triglyceride–glucose index and long-term frailty progression and transition in Chinese adults

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  • 发表日期：

    2026年1月11日

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  • Huihe Chen,
  • Wei Xiang,
  • Ke-Ke Yan,
  • Yanrong Huang,
  • Zhenbai Qin,
  • Zhengzhao Li,
  • Xiaomin Wang,
  • Jianfeng Zhang

摘要

Evidence on the longitudinal relationship between the triglyceride–glucose (TyG) index and different frailty progression and transition patterns, especially the early onset of frailty, is scarce. Participants aged 45 years and older were enrolled from the nationally representative cohort of China Health and Retirement Longitudinal Study (CHARLS). Frailty status was repeatedly assessed by a deficit-accumulated frailty index (FI) during a 7-year follow-up. Restricted cubic spline, linear mixed model, and Cox regression model were used to examine the associations between frailty progression and transition. In total, 8,510 participants were included. The TyG index was positively associated with FI. Each unit increment in TyG index predicted 0.00126 (95%CI: 0.00068–0.00184, p < 0.0001) increase in FI per year. Compared to maintained stable status, TyG index showed positive associations with worsened transitions to pre-frail (OR: 1.14, 95%CI: 1.02–1.26, p = 0.018) and frail (OR:1.14, 95%CI: 1.03–1.27, p = 0.015) status. In contrast, a lower TyG index was inversely associated with improved frailty transitions among women (OR: 0.76, 95%CI: 0.61–0.94, p = 0.010), with a significant TyG × sex interaction (p = 0.021). A similar inverse trend was observed among adults under 60 years (OR: 0.68, 95%CI: 0.531–0.88, p = 0.003), although the TyG × age group interaction was not statistically significant (p = 0.988). A J-shaped relationship was identified between TyG index and frailty onset, with thresholds of 9.10 for the transition from robust to pre-frail and 9.14 for the transition from robust to frail. Above these thresholds, each unit increase in TyG index was significantly associated with a 35% and a67% higher risk of pre-frail (HR 1.35, 95%CI: 1.11–1.65, p = 0.003) and frail transition (HR 1.67, 95%CI: 1.04–2.68, p = 0.035), respectively. Below these thresholds, the associations were insignificant. The main findings remained largely consistent across various sensitivity analyses. The TyG index may serve as a feasible indicator for screening and monitoring of frailty progression and transition. A TyG index greater than 9.10 may be the optimal threshold for predicting the early onset of frailty.