Evidence map›Paper›PMID 41427564›Full record

ArticleInternational journal of surgery (London, England)2026

Association between frailty index and hip fracture among Chinese middle- and old-aged adults in different glycemic status: a prospective study from the China Health and Retirement Longitudinal Study (CHARLS).

Xianlong Li, Huachuan Wu, Zesheng Zhang, Jun Zhu, Linkun Wu, Weifan Lin, Yining Chen, Jiaxiang Zhou, Manman Gao, Shunyou Chen

Abstract read
In one paragraph

Article in International journal of surgery (London, England), 2026. 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.

  1. Article
  2. Observational
  3. Article
  4. Article
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

10 authors.

Xianlong LiDepartment of Orthopedics, Fuzhou Second General Hospital, Fuzhou, China.ORCID 0000-0002-7484-3487
Huachuan WuDepartment of Orthopedics, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
Zesheng ZhangFujian University of Traditional Chinese Medicine, Fuzhou, China.
Jun ZhuDepartment of Clinical Laboratory, Fuzhou Second General Hospital, Fuzhou, China.
Linkun WuDepartment of Orthopedics, Fuzhou Second General Hospital, Fuzhou, China.
Weifan LinFujian University of Traditional Chinese Medicine, Fuzhou, China.
Yining ChenDepartment of Orthopedics, Fuzhou Second General Hospital, Fuzhou, China.
Jiaxiang ZhouInnovation Platform of Regeneration and Repair of Spinal Cord and Nerve Injury, Department of Orthopedic Surgery, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.
Manman GaoOrthopedic Research Institute, Fuzhou Second General Hospital, Fuzhou, China.
Shunyou ChenDepartment of Orthopedics, Fuzhou Second General Hospital, Fuzhou, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFrailty and diabetes are recognized as risk factors for hip fracture. However, the specific association between frailty and the risk of hip fracture, particularly in individuals with different glycemic statuses, remains to be explored.

objectiveThis study focused on evaluating the predictive value of a 35-item frailty index (FI35) in assessing hip fracture risk under different glycemic states.

methodsThis study was a prospective cohort study, enrolled a total of 10 049 middle-aged and elderly participants from the China Health and Retirement Longitudinal Study. The primary outcome was the first occurrence of hip fracture events. Frailty status was calculated using an FI35. We used Kaplan-Meier curves, Cox proportional hazard models, and restricted cubic spline analysis to analyze the association between frailty and hip fracture risk according to gender, age, and glycemic status.

resultsDuring a follow-up of 9 years, 629 (6.26%) participants experienced a hip fracture. Our findings revealed a significant positive linear relationship between FI35 and the incidence of hip fracture. This association was similar between men and women, although the hazard ratio (HR) tended to be slightly higher in women [HR 1.59, 95% confidence interval (CI) 1.39, 1.83] than in men (HR 1.55, 95% CI 1.31, 1.85). The association was also similar between middle-aged (HR 1.44, 95% CI 1.20, 1.73) and elderly participants (HR 1.62, 95% CI 1.44, 1.85). In individuals with different glycemic statuses, higher levels of FI35 were linked to an increased risk of hip fracture in those with normal glucose regulation (HR 1.46, 95% CI 1.24, 1.71), prediabetes mellitus HR 1.60, 95% CI 1.35, 1.90), and diabetes mellitus (HR 1.90, 95% CI 1.49, 2.42).

conclusionOur findings indicate a significant positive linear relationship between frailty and the occurrence of hip fracture. The association between FI and hip fracture was similar between male and female participants, and similar in middle-aged and elderly participants. In different glycemic status, the risk of hip fracture increases with worsening glycemic status. GRAPHICAL ABSTRACT:

Indexed as

CHARLSfrailty indexglycemic statuship fractureprosepctive cohort study

Identifiers

PMID41427564
PMCPMC13105706

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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 OpenQuestion graph.