Objective:The aim of this study was to explore the effect of frailty status and frailty index(FI)on the development of new-onset diabetes mellitus in patients with hypertension.Methods:This was a retrospective cohort study,enrolling 953 patients with hypertension.Patients were grouped according to FI:frail group(FI＞0.21),prefrail group(0.10＜FI ≤ 0.21),and healthy group(FI＜0.10).The primary endpoint was the occurrence of new-onset diabetes.The effect of frailty status on new-onset diabetes was explored by multivariate Cox regression analyses,and the results were expressed using hazard ratios(HR)and 95％confidence intervals(CI).Kaplan-Meier curves and restricted cubic spline(RCS)were also plotted to visualize the relationship between FI and new-onset diabetes.Subgroup analyses were also performed.Results:The incidence of new-onset diabetes mellitus was significantly higher in patients as the degree of frailty worsened(healthy group vs.prefrail group vs.frail group:12,4.2％vs.34,8.5％vs.38,14.2％,P＜0.001).The Kaplan-Meier curves indicated that patients in the prefrail and the frail groups had a significantly higher risk of new-onset diabetes mellitus than those in the healthy group.The results of multivariate Cox regression after adjusting for confounders showed that the frail group significantly elevated the risk of new-onset diabetes in the patients compared to the healthy group(HR=3.14,95％CI:1.50-6.58,P=0.002),which was an independent risk factor for new-onset diabetes,whereas there was no such effect in the prefrail group(HR=1.88,95％CI:0.95-3.74,P=0.071).The results of the RCS curve showed that the relationship between FI and new-onset diabetes was linear,indicating an increased risk of developing diabetes with higher levels of FI.The results of the subgroup analyses showed no significant interaction between the subgroups and frailty status.Conclusions:In patients with hypertension,frailty status was an independent risk factor for new-onset diabetes,and FI was linearly and positively associated with the risk of new-onset diabetes.
维普
万方数据