Association of frailty and metabolism with multi-state model in fatty liver disease, diabetes mellitus and all-cause mortality

Diabetology & Metabolic Syndrome

卷:18

Research

Xiaoyan Wang¹  Chenxi Jin¹  Qi Zhong²  Xiaomeng Wang¹  Yining Xu¹  Meixuan Li¹  Lu Liu¹  Hui Huang¹  Anying Liang¹  Jing Wang¹  Xianbo Wu^1,2  Linna Li¹  Mengchen Zou¹ 

[1] Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Road North, 510515, Guangzhou, China

[2] Department of Occupational Health and Medicine, School of Public Health, Southern Medical University, Guangzhou, China

关键词: Frailty phenotype;    Metabolic syndrome;    Multi-state model;    Metabolic-associated fatty liver disease;    Non-insulin-dependent diabetes mellitus;   

DOI  :  10.1186/s13098-026-02201-4

 received in 2026-03-05, accepted in 2026-05-27,  发布年份 2026

来源: Springer

【 摘 要 】

ObjectiveFrailty is a global public health issue, and metabolic syndrome (MetS) is also associated with a variety of adverse health outcomes. However, the relationship between the combined effects of these two factors and the occurrence and progression of long-term diseases remains unclear.MethodsThis is a population-based cohort study involving 165,555 participants from the UK Biobank. We combined frailty status scores with metabolic condition scores to assess the predictive value. Associations were assessed using multi-state model, corrected Cox models, restricted cubic spline, stratified analysis, Kaplan-Meier analysis.ResultsDuring the 12.7-year follow-up period, 3,585 individuals were newly diagnosed with metabolic-associated fatty liver disease (MAFLD), among whom 170 developed non-insulin-dependent diabetes mellitus (NIDDM) and 699 died from all causes. Compared with Group 1(neither frailty nor MetS), the HR and 95% confidence intervals for Group 4 (both frailty and MetS) was 2.92 (2.45–3.47) for MAFLD, 4.21 (2.23–7.96) for MAFLD→NIDDM, and 1.22 (0.75–2.02) for MAFLD→Death. The Kaplan-Meier analysis further confirmed these findings. Consistent findings regarding the frailty phenotype and MetS had also been observed in the progression of NIDDM.ConclusionThis study demonstrates a positive association between frailty phenotype and MetS in disease onset and progression, and their combined assessment enables a more effective early risk stratification.

【 授权许可】

CC BY-NC-ND   
© The Author(s) 2026

【 图 表 】

Fig. 5

Fig. 3 Severity of symptoms in patients with Immune effector cell-associated nerve palsy (IEC-NP).