PMID- 37875981
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231122
IS  - 1758-5996 (Print)
IS  - 1758-5996 (Electronic)
IS  - 1758-5996 (Linking)
VI  - 15
IP  - 1
DP  - 2023 Oct 24
TI  - Association of frailty index with congestive heart failure, all-cause and 
      cardiovascular mortality among individuals with type 2 diabetes: a study from 
      National Health and Nutrition Examination Surveys (NHANES), 1999-2018.
PG  - 210
LID - 10.1186/s13098-023-01165-z [doi]
LID - 210
AB  - BACKGROUND: Both type 2 diabetes mellitus (T2DM) and frailty are strongly 
      associated with congestive heart failure (CHF). Individuals with T2DM and CHF 
      have a high frailty burden. The association of frailty with HF, all-cause, and 
      cardiovascular mortality in patients with T2DM has not been thoroughly explored. 
      METHODS: This study included 2894 adults with T2DM from the National Health and 
      Nutrition Examination Survey (NHANES) database over ten cycles (1999-2018) and 
      followed up for all-cause and cardiovascular mortality through 31 December 2019. 
      The frailty index (FI) was calculated using a 46-item deficit model to assess 
      frailty status. Weighted multivariable logistic regression was performed to 
      explore the relationship between frailty and CHF in patients with T2DM. Weighted 
      restricted cubic splines were used to evaluate the non-linear relationship 
      between FI and outcome. All-cause mortality and cardiovascular mortality 
      association with FI was assessed using the Kaplan-Meier curve and COX 
      proportional hazards regression accounting for sampling weights. Subgroup and 
      sensitivity analyses were performed to evaluate the robustness of the results. 
      RESULTS: After the adjustment of essential confounders, a higher frailty index in 
      T2DM was associated with increased odds of CHF (odds ratio [OR] for per 1-SD 
      increase, 2.02, 95% confidence interval [CI] 1.67-2.45; P < 0.0001). The presence 
      of frailty T2DM (OR, 3.60; 95% CI 2.34-5.54; P < 0.0001) was associated with a 
      significant increase in the prevalence of CHF compared to non-frailty T2DM in a 
      fully adjusted model. During the median follow-up of 6.75 years, per 1-SD 
      increase in FI was associated with a 41% higher risk of all-cause mortality and a 
      30% higher risk of cardiovascular mortality after being adjusted for all 
      confounders. Similar results were observed when sensitivity analyses were 
      performed. There was also a non-linear relationship between FI and all-cause 
      mortality. In a weighted multivariate COX proportional model adjusted for full 
      confounders, frailty T2DM increased all-cause (HR, 1.86; 95% CI 1.55-2.24; 
      P < 0.0001) and cardiovascular (HR 1.66; 95% CI 1.18-2.33; P = 0.003) mortality 
      and compared to non-frailty T2DM. The positive association of frailty index and 
      all-cause mortality was only in participants without CHF. The positive 
      association of frailty index and cardiovascular mortality was only in 
      non-anti-diabetic drug users. CONCLUSIONS: Frailty index in T2DM was positively 
      associated with CHF in linear fashions. The Frailty index was positively 
      correlated with all-cause and cardiovascular death in patients with T2DM. Frailty 
      T2DM was positively associated with CHF, all-cause mortality, and cardiovascular 
      mortality compared to non-frailty T2DM. Promoting frailty measurement and 
      management in T2DM may be beneficial to reduce the burden of CHF and mortality.
CI  - (c) 2023. BioMed Central Ltd., part of Springer Nature.
FAU - Qin, Yu-Nan
AU  - Qin YN
AD  - Department of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong 
      University, 277 Yanta West Street, Xi'an, 710061, Shaanxi, People's Republic of 
      China.
AD  - Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, Shaanxi, 
      China.
FAU - Zheng, Xiao-Pu
AU  - Zheng XP
AD  - Department of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong 
      University, 277 Yanta West Street, Xi'an, 710061, Shaanxi, People's Republic of 
      China. zhengxp001@xjtufh.edu.cn.
AD  - Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, Shaanxi, 
      China. zhengxp001@xjtufh.edu.cn.
LA  - eng
PT  - Journal Article
DEP - 20231024
PL  - England
TA  - Diabetol Metab Syndr
JT  - Diabetology & metabolic syndrome
JID - 101488958
PMC - PMC10594933
OTO - NOTNLM
OT  - Congestive heart failure
OT  - Diabetes
OT  - Frailty index
OT  - Mortality
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      competing interests.
EDAT- 2023/10/25 00:42
MHDA- 2023/10/25 00:43
PMCR- 2023/10/24
CRDT- 2023/10/24 23:58
PHST- 2023/04/24 00:00 [received]
PHST- 2023/09/18 00:00 [accepted]
PHST- 2023/10/25 00:43 [medline]
PHST- 2023/10/25 00:42 [pubmed]
PHST- 2023/10/24 23:58 [entrez]
PHST- 2023/10/24 00:00 [pmc-release]
AID - 10.1186/s13098-023-01165-z [pii]
AID - 1165 [pii]
AID - 10.1186/s13098-023-01165-z [doi]
PST - epublish
SO  - Diabetol Metab Syndr. 2023 Oct 24;15(1):210. doi: 10.1186/s13098-023-01165-z.