中国医学前沿杂志（电子版）2026，Vol.18Issue(4)：41-48,8.DOI:10.12037/YXQY.2026.04-06
血浆动脉粥样硬化指数轨迹与衰弱前期进展为衰弱的相关性:一项基于社区人群的队列研究
Association between the trajectories of the atherogenic index of plasma and pre-frailty progression to frailty:A community-based cohort study
摘要
Abstract
Objective This study aimed to investigate the long-term dynamic trajectories of the atherogenic index of plasma(AIP)in a community-dwelling elderly population and assess their association with the risk of progression from pre-frailty to frailty.Methods A retrospective cohort analysis was conducted using longitudinal data from the"Kunshan Aging Research with E-health"(KARE)cohort.Community-dwelling elderly adults aged≥65 years who were assessed as pre-frail between 2018 and 2020,had three valid annual health check-up records,and had at least one health check-up record between 2021 and 2024.Growth Mixture Modeling(GMM)was employed to identify distinct long-term AIP trajectories over the 2018-2020 period.The primary outcome was the first occurrence of frailty during the follow-up from 2021 to 2024.Cox proportional hazards regression models were used to analyze the relationship between different AIP trajectory groups and the risk of frailty progression,adjusting for potential confounders such as age and sex.Subgroup analyses were also performed based on sex,age,education and comorbidities.Results A total of 16 637 pre-frail elderly adults were included,with an age of(76.14±5.92)years,and a mean follow-up of 4.5 years.GMM identified three distinct AIP trajectories:moderate-risk stable(39.7％),low-risk rising(39.9％),and high-risk rising(20.4％).Compared with the moderate-risk stable group,the high-risk ascending group showed a significantly increased risk of progression to frailty after adjusting for age,sex,education level,smoking,and alcohol consumption(HR=1.100,P=0.006).The low-risk rising group showed no significant association with frailty progression.Subgroup analysis revealed that the association between high-risk AIP trajectories and frailty progression was strongest in the≥65-<75 age group(HR=1.128,P=0.024),among individuals without a history of stroke(HR=1.122,P=0.003),no history of cardiovascular disease(HR=1.091,P=0.019),and a history of hypertension(HR=1.094,P=0.015).Conclusions Among community-dwelling pre-frail elderly adults,a long-term trajectory characterized by high and persistently rising AIP levels is an independent risk factor for progression to frailty.AIP trajectories,particularly the high-risk rising pattern,can serve as a useful indicator for identifying high-risk subgroups.关键词
血浆动脉粥样硬化指数/衰弱/衰弱前期/老年人/轨迹Key words
Atherogenic index of plasma/Frailty/Pre-frailty/Elderly/Trajectory引用本文复制引用
颜丹娜,顾浩宇,赵梦杰,李羽佳,张菁璐,潘颖..血浆动脉粥样硬化指数轨迹与衰弱前期进展为衰弱的相关性:一项基于社区人群的队列研究[J].中国医学前沿杂志（电子版）,2026,18(4):41-48,8.基金项目
苏州市临床试验机构能力提升项目(SLT2023019) （SLT2023019）
姑苏卫生人才计划人才科研项目(GSWS2022106) （GSWS2022106）
中央高水平医院临床科研项目(BJ2024144) Suzhou Clinical Trial Institution Capacity Enhancement Project(SLT2023019) （BJ2024144）
Gusu Health Talent Program Scientific Research Project(GSWS2022106) （GSWS2022106）
Central High-Level Hospital Clinical Research Project(BJ2024144) （BJ2024144）
