中国中老年人锥度指数与衰弱风险的关联性OA
Association between conicity index and frailty in Chinese middle and old-aged adults
目的 分析锥度指数与衰弱发生风险之间的关系,明确其衰弱预测能力,为早期衰弱预防及衰弱管理措施的制定提供理论依据.方法 基于中国健康与养老追踪调查(CHARLS)数据,使用Cox比例风险回归模型分析锥度指数与衰弱发生风险的关联,限制性立方样条(RCS)探究二者非线性剂量-反应关系.采用受试者工作特征(ROC)曲线和时间依赖性ROC评估锥度指数对衰弱的预测性能.结果 完全调整的Cox回归模型中,锥度指数每增加0.1个单位,衰弱风险增加14.0%(HR=1.140,95%CI 1.086～1.196,P<0.001).对锥度指数进行三分位数分组,与最低水平组相比,最高水平组衰弱风险增加27.1%(HR=1.271,95%CI 1.138～1.420,P<0.001).趋势性检验显示随着锥度指数三分位数水平升高,衰弱风险呈上升趋势(P趋势<0.001).RCS结果显示,锥度指数与衰弱发生风险之间呈J型非线性关系(P总体<0.001,P非线性=0.001),当锥度指数>1.2时衰弱风险呈快速上升趋势.ROC和时间依赖性ROC结果显示,与体质量指数(AUC=0.525,95%CI 0.512～0.538)和腰围(AUC=0.550,95%CI 0.537～0.562)相比,锥度指数的衰弱预测性能最好(AUC=0.600,95%CI 0.587～0.613),且随着随访年的延长,锥度指数对衰弱的预测性能逐渐增强.结论 中国中老年人群中锥度指数与衰弱存在显著正相关关系,锥度指数可成为衰弱预防和衰弱管理的潜在有效指标.
Objective To analyze the relationship between conicity index and the risk of frailty occurrence,and clarify its predictive capacity for frailty,providing a theoretical basis for early frailty prevention and formulation of frailty management strategies.Methods Based on data from the China Health and Retirement Longitudinal Study(CHARLS),Cox proportional hazards regression models were employed to examine the association between conicity index and the risk of frailty incidence.Restricted cubic splines(RCS)were utilized to explore potential non-linear dose-response relationships between these variables.The predictive performance of conicity index for frailty was evaluated using receiver operating characteristic(ROC)curves and time-dependent ROC analysis.Results In fully adjusted Cox regression model,each 0.1-unit increase in conicity index was associated with a 14.0%elevated risk of frailty(HR=1.140,95%CI 1.086-1.196,P<0.001).When conicity index was stratified into tertiles,compared with the lowest tertile,the highest tertile of conicity index demonstrated a 27.1%increased risk of frailty(HR=1.271,95%CI 1.138-1.420,P<0.001).A significant trend test showed that the risk of frailty increased with elevated tertile levels of conicity index(Ptrend<0.001).RCS analysis revealed a J-shaped nonlinear relationship between conicity index and frailty incidence risk(Poverall<0.001;Pnon-linear=0.001),and the risk of frailty rose rapidly when conicity index exceeded 1.2.ROC and time-dependent ROC analyses results demonstrated that conicity index had the best predictive performance for frailty(AUC=0.600,95%CI 0.587-0.613)compared with body mass index(AUC=0.525,95%CI 0.512-0.538)and waist circumference(AUC=0.550,95%CI 0.537-0.562).Moreover,the predictive ability of conicity index for frailty increased gradually with increasing follow-up years.Conclusion Conicity index is positively associated with the frailty among Chinese middle and old-aged adults,and it may serve as a potentially effective indicator for frailty prevention and management.
杨玉玲;荆晓欢;杨秀娟;周立业
山西省肿瘤医院,中国医学科学院肿瘤医院山西医院,山西医科大学附属肿瘤医院中心实验室,太原 030013山西医科大学管理学院山西医科大学公共卫生学院卫生检验与检疫教研室山西医科大学管理学院
医药卫生
锥度指数衰弱中老年人CHARLS纵向研究预测性能
conicity indexfrailtymiddle and old-aged adultsCHARLSlongitudinal studypredictive performance
《山西医科大学学报》 2026 (5)
548-554,7
国家自然科学基金项目(32301421)
评论