ArticleEuropean journal of medical research2026
Prospective association between the triglyceride-glucose index and frailty in middle-aged and older adults: insights from a nationwide cohort study.
Article in European journal of medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
backgroundFrailty is notably prevalent in individuals aged 50 and older and has been associated with metabolic dysfunction. The triglyceride-glucose (TyG) index is a reliable surrogate marker for insulin resistance. This study aimed to investigate the association between the TyG index and frailty in middle-aged and older Chinese adults.
methodsThis study used 7-year data from wave 1 (2011) to wave 4 (2018) in the China Health and Retirement Longitudinal Study. Using the Rockwood frailty index (FI), participants were categorized as non-frail (FI < 0.25) or frail (FI ≥ 0.25). The TyG index was calculated as ln [fasting triglyceride (mg/dL) × fasting plasma glucose (mg/dL)/2]. TyG trajectories were analyzed using data in wave 1 and wave 3 (2015). Associations were assessed using logistic and Cox regression models.
resultsAt baseline in 2011, among 6,003 participants (median age, 60 years; 51.2% men), there were 684 cases of prevalent frailty. Cross-sectionally, the TyG index was not associated with frailty. In the prospective analysis of 3957 participants (median age, 60 years; 51.8% men), 1427 developed new-onset frailty during the 7-year follow-up. Compared with participants in the lowest tertile (T1), those in TyG index tertiles 2 and 3 had a 1.16-fold (hazard ratio [HR], 1.16; 95% CI 1.02-1.33; P = 0.03) and 1.19-fold (HR, 1.19; 95% CI 1.03-1.39; P = 0.02) higher risk of new-onset frailty, respectively. Each 1-unit increase in the TyG index was associated with an 18% increase in the risk of new-onset frailty (HR, 1.18; 95% CI 1.08-1.30; P < 0.01). Trajectory analysis identified three longitudinal patterns of the TyG index: "stable" (n = 3505, 87.2%), "increase" (n = 413, 10.3%), and "rapid decrease" (n = 100, 2.5%). After adjusting for covariates, participants in the "increase" trajectory had a significantly higher risk of frailty (HR, 1.30; 95%CI 1.01-1.69; P < 0.05) compared with those in the "stable" trajectory.
conclusionsElevated metabolic risk, as evaluated by the TyG index, was prospectively associated with an increased risk of frailty in middle-aged and older adults, although cross-sectional analysis was negative. These results suggest that the TyG index may serve as a valuable biological marker for identifying individuals at risk of future frailty.
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