Digestive diseases (Basel, Switzerland) · 2026
Association of Frail Status with Incident Digestive Diseases: A Large Prospective Cohort Study.
СтатьяНазвание и аннотация: Перевод в очереди
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Qin Zihan, Shi Lubo, Zhang Kun, Pan Mincong, Liu Yifei, Peng Jiafei, Zhang Yaohang, Zhang Zinan, Zhang Shutian, Wei Hongtao
Аннотация
INTRODUCTION: Frailty, reflecting age-related decline in physiological reserve, has been implicated in adverse health outcomes, but its contribution to digestive disease risk is not well established.
METHODS: Leveraging two prospective cohorts from the UK Biobank (n ≈ 340,000 and n ≈ 358,000) with participants free of gastrointestinal diseases (GID) or hepatobiliary-pancreatic diseases (HBPD) at baseline, we evaluated incident disease over a median follow-up of 13.7 years using a validated frailty phenotype.
RESULTS: Individuals classified as frail showed consistently higher rates of digestive disorders than robust peers. After multivariable adjustment, hazard ratios (HRs) for frailty were 1.65 (95% confidence interval [CI]: 1.57-1.72) for overall GID and 1.78 (95% CI: 1.66-1.92) for HBPD. Risk elevations were observed for gastroesophageal reflux disease (HR: 1.70), peptic ulcer (HR: 1.81), inflammatory bowel disease (IBD) (HR: 1.48), irritable bowel syndrome (HR: 2.43), diverticulosis (HR: 1.38), constipation (HR: 2.25), coeliac disease (HR: 1.58), cirrhosis (HR: 2.22), metabolic dysfunction-associated steatotic liver disease (HR: 1.76), gallbladder disease (HR: 1.69), and pancreatic disease (HR: 1.60), all with p values of <0.01. Subgroup analyses across age, sex, adiposity, and comorbidity strata yielded similar results. Exploratory mediation using the C-reactive protein-to-albumin ratio, an index of inflammation and nutritional status, suggested partial attenuation of the frailty-disease associations (up to 9.5% for IBD and 4.1% for cirrhosis). Excluding early events and adding extensive lifestyle and biochemical covariates did not materially change the findings.
CONCLUSION: Frailty, including pre-frail states, appears to be an independent marker of vulnerability to a broad range of digestive diseases, supporting its potential use in early risk assessment and targeted preventive strategies.
METHODS: Leveraging two prospective cohorts from the UK Biobank (n ≈ 340,000 and n ≈ 358,000) with participants free of gastrointestinal diseases (GID) or hepatobiliary-pancreatic diseases (HBPD) at baseline, we evaluated incident disease over a median follow-up of 13.7 years using a validated frailty phenotype.
RESULTS: Individuals classified as frail showed consistently higher rates of digestive disorders than robust peers. After multivariable adjustment, hazard ratios (HRs) for frailty were 1.65 (95% confidence interval [CI]: 1.57-1.72) for overall GID and 1.78 (95% CI: 1.66-1.92) for HBPD. Risk elevations were observed for gastroesophageal reflux disease (HR: 1.70), peptic ulcer (HR: 1.81), inflammatory bowel disease (IBD) (HR: 1.48), irritable bowel syndrome (HR: 2.43), diverticulosis (HR: 1.38), constipation (HR: 2.25), coeliac disease (HR: 1.58), cirrhosis (HR: 2.22), metabolic dysfunction-associated steatotic liver disease (HR: 1.76), gallbladder disease (HR: 1.69), and pancreatic disease (HR: 1.60), all with p values of <0.01. Subgroup analyses across age, sex, adiposity, and comorbidity strata yielded similar results. Exploratory mediation using the C-reactive protein-to-albumin ratio, an index of inflammation and nutritional status, suggested partial attenuation of the frailty-disease associations (up to 9.5% for IBD and 4.1% for cirrhosis). Excluding early events and adding extensive lifestyle and biochemical covariates did not materially change the findings.
CONCLUSION: Frailty, including pre-frail states, appears to be an independent marker of vulnerability to a broad range of digestive diseases, supporting its potential use in early risk assessment and targeted preventive strategies.