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Association of estimated carotid-femoral pulse wave velocity with frailty in middle-aged and older adults with cardiometabolic disease

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Abstract

Purpose

The prevalence of frailty in individuals with cardiometabolic disease (CMD) has become a growing concern in public health. The purpose of this study was to investigate the association between estimated pulse wave velocity (ePWV) and frailty in middle-aged and older adults with CMD.

Methods

We analyzed data from 23,313 non-institutionalized adults with CMD from the National Health and Nutrition Examination Survey 2003–2018. Frailty status was determined using the frailty index, and logistic regression models were used to assess the association of ePWV with frailty risk. Multivariable logistic regression and propensity-score matching (PSM) were used to adjust for potential confounders. The restricted cubic spline regression model was used to evaluate the non-linear association between ePWV and frailty risk.

Results

After adjusting for potential confounding factors, we found that each one m/s increase in ePWV was associated with a 15% higher risk of frailty (odds ratio [OR] = 1.15, 95% confidence interval [CI] 1.12 to 1.18, P < 0.001). After PSM, the association remained significant (OR = 1.05, 95% CI 1.03 to 1.08, P < 0.001). The logistic models with restricted cubic splines showed a non-linear dose–response association, with the risk of frailty increasing more rapidly when ePWV exceeded 9.5 m/s.

Conclusions

The findings of this study suggest that a higher level of ePWV is associated with an increased risk of frailty in middle-aged and older adults with CMD, and may serve as a viable alternative to directly measured cfPWV.

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Data availability

The NHANES datasets are publicly available in “www.cdc.gov/nchs/nhanes/”.

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Acknowledgements

The authors thank all contributors and participants of NAHNES.

Funding

This work was supported by the National Natural Science Foundation of China (Grant no. 81974566) and the Jinan “University 20” Project (Grant no. 2020GXRC017).

Author information

Authors and Affiliations

  1. First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Lixia District, Jinan, Shandong, China

    Yuanlong Hu, Jiaming Huan & Yunlun Li

  2. Shandong Province Engineering Laboratory of Traditional Chinese Medicine Precise Diagnosis and Treatment of Cardiovascular Disease, Shandong University of Traditional Chinese Medicine, Lixia District, Jinan, Shandong, China

    Yuanlong Hu, Jiaming Huan, Lin Lin, Lei Zhang & Yunlun Li

  3. Faculty of Chinese Medicine, Macau University of Science and Technology, Taipa, Macau, China

    Xiaojie Wang

  4. Innovative Institute of Chinese Medicine and Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China

    Lin Lin

  5. Experimental Center, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China

    Yuan Li

  6. Key Laboratory of Traditional Chinese Medicine Classical Theory, Ministry of Education, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China

    Yuan Li

  7. Shandong Provincial Key Laboratory of Traditional Chinese Medicine for Basic Research, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China

    Yuan Li

  8. College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China

    Lei Zhang

  9. Department of Cardiovascular, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Lixia District, Jinan, Shandong, China

    Yunlun Li

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Contributions

YLH conducted analyses and wrote the article. XJW, JMH, LZ, LL, and YL collected and assembled the data. YLH and YLL conceived the study design. All authors have contributed to the interpretation of the results and have critically revised the content of the manuscript. All authors agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Yunlun Li.

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Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the National Center for Health Statistics (NCHS) Research Ethics Review Board (Protocols #98-12, #2005-06, #2011-17, and #2018-01).

Statement of human and animal rights

This study does not include any animal studies conducted by the authors and adheres to the guidelines for conducting research involving human participants.

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NHANES is a public dataset and all participants provided a written informed consent.

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Hu, Y., Huan, J., Wang, X. et al. Association of estimated carotid-femoral pulse wave velocity with frailty in middle-aged and older adults with cardiometabolic disease. Aging Clin Exp Res 35, 2425–2436 (2023). https://doi.org/10.1007/s40520-023-02556-y

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