Aim: Frailty is an important risk factor for a wide range of chronic diseases and for mortality risk. This study aims to explore the relationship between frailty and incidence of chronic kidney disease (CKD), particularly on the change and accumulation of frailty. Methods: Frailty status was assessed using the frailty index (FI, constructed by 31 items) and categorized as robust, pre-frail, and frail. The accumulation and change in frailty were assessed on the basis of frailty status at baseline and a second survey 4 years after baseline. Logistic regression was used to estimate the association between frailty and developing CKD. Results: A total of 3597 participants (mean age: 59.08 ± 8.94 years old, male: 49.9%) from CHARLS were included. Participants with pre-frailty or frailty status had a higher risk of developing CKD compared with robust participants (pre-frail vs robust, OR 1.78, 95% CI 1.37–2.32, p < 0.001; frail vs robust, OR 2.52, 95% CI 1.67–3.79, p < 0.001). Participants who had a robust status in the two surveys had a significantly lower risk of developing CKD (OR 0.51, 95% CI 0.36–0.75, p < 0.001) compared with those who never had a robust status. Conclusion: Frailty status is significantly associated with the incidence of CKD. The risk of CKD was lower in those who ever had a robust status than in participants who never had a robust status.

Background Body mass index (BMI) is strongly associated with the development of type 2 diabetes. However, the association between long-term time in target range (TTR) for BMI and the incidence of new-onset diabetes remains unclear. Methods and results This study utilized a non-diabetic population aged 45 years or older from the China Health and Retirement Longitudinal Study (CHARLS). BMI-TTR was assessed in Waves 1, 2, and 3 over a 5-year period, with the target range defined as 18.5 kg/m² ≤ BMI < 23 kg/m². New-onset diabetes in Waves 2, 3, and 4 over a 6-year follow-up served as the study endpoint. After applying exclusion criteria, 6662 participants (3143 men and 3519 women; mean age 58.93 ± 8.85 years) were enrolled. Participants were categorized into four groups (TTR1–TTR4) based on the number of times BMI was within the target range (0–3 times). The risk of new-onset diabetes decreased progressively with increasing BMI-TTR during follow-up. Compared with the TTR1 group, participants in the TTR4 group exhibited a significantly lower risk of diabetes (adjusted HR: 0.577, 95% CI: 0.463–0.720, P < 0.001), even after adjusting for baseline BMI (adjusted HR: 0.685, 95% CI: 0.537–0.872, P = 0.002). This effect was even more pronounced in female subgroup and in individuals aged under 60 years of age. Conclusion In adults aged 45 years or older, regardless of baseline BMI, maintaining BMI within the target range over time was associated with a reduced risk of new-onset diabetes, particularly among women and individuals under 60 years of age. These findings highlight the importance of long-term weight management in diabetes prevention.

Background: The current burden of dyslipidemia, the pre-hospital application of statins and the association of pre-hospital statins with the severity of coronary artery disease (CAD) and in-hospital outcomes in Chinese patients with first acute coronary syndrome (ACS) are very significant and remain unclear.Methods: A total of 41,183 patients who underwent coronary angiography and were diagnosed with ACS for the first time from a nationwide registry study (CCC-ACS) were enrolled. The severity of CAD was assessed using the CAD prognostic index (CADPI). The patients were classified into statin and non-statin groups according to their pre-hospital statin treatment status. Clinical characteristics, CADPI and in-hospital outcomes were compared, and a logistic regression analysis was performed to determine whether pre-hospital statin therapy is associated with in-hospital outcomes and CADPI. A sensitivity analysis was used to further explore the issues above.Results: The non-statin group had more in-hospital all-cause deaths (1.2 vs. 0.8%, P = 0.010). However, no association exists between statin pretreatment and in-hospital major adverse cardiovascular events (MACEs) or all-cause deaths in the entire population and subgroups (all P > 0.05). Surprisingly, statin pretreatment was associated with an 8.9% higher risk of severely obstructive CAD (CADPI ≥ 37) (OR, 1.089; 95% CI, 1.010–1.175, P = 0.028), and similar results were observed in subgroups of females, those aged 50 to 75 years, and patients with hypertension.Conclusion: Statin pretreatment was not related to MACEs or all-cause death during hospital stay, but it was associated with a higher risk of increased angiographic severity in patients with first ACS.

Background: C-reactive protein (CRP) plays a pivotal role in acute coronary syndrome(ACS) and diabetes mellitus (DM). Few data from non-diabetic ACS populations on the association of high-sensitivity CRP (hs-CRP) and long-term prognosis are available. This study aimed to investigate the relationship between baseline hs-CRP and the 2-year major cardiovascular and cerebrovascular adverse events (MACCEs) following percutaneous coronary intervention (PCI) of non-diabetic patients with ACS. Methods: We divided participants (n=419)into two groups according to baseline hs-CRP level to compare baseline characteristics and clinical outcomes. Cox regression and survival analysis of MACCE was performed at a median follow-up of 32.43 months. We also plot the receiver operating characteristics (ROC) curves of hs-CRP in predicting 2-year MACCEs. Results: The incidence of MACCEsin the lower-hs-CRP (L-CRP) (12.4%) group was higher than that in the higher-hs-CRP (H-CRP) (5.6%) group (P = 0.020). In COX regression analysis, the H-CRP (HR 0.975, 95% CI 0.637-0.992, P= 0.043) group was associated with lower MACCEs compared with the L-CRP group after adjusting for confounders. Conclusion: Elevated baseline hs-CRP levels may be a protector maker in predicting a lower incidence of MACCEs following PCI in ACS patients without glucose metabolism disorder.

Thyroid-stimulating hormone (TSH) is related to increased atrial fibrillation (AF) inducibility and plays an important role in a variety of cardiovascular diseases. However, the association of baseline TSH with in-hospital outcomes in patients with AF and coronary artery disease (CAD) is unknown. This study aimed to investigate the distribution of baseline TSH and its association with in-hospital outcomes (major adverse cardiovascular events [MACE], all-cause death, or heart failure [HF]) in AF patients combined with CAD. A total of 19,725 patients with AF were included. The status of blood TSH was investigated. Patients with AF and CAD were divided into low, median, and high-TSH subgroups based on tertiles of baseline TSH levels. Clinical characteristics and in-hospital outcomes were compared. Logistic regression analysis was performed to determine the association of TSH with in-hospital outcomes. Subgroup analysis was also performed. In patients with AF and CAD, compared with the low-TSH group, the median-TSH (OR 0.277, 95% CI 0.078-0.991, P = 0.048) and high-TSH (OR 0.163, 95% CI 0.036-0.750, P = 0.020) groups were associated with decreased all-cause death. Besides, high TSH showed a protective role for HF events, and the same results were seen in females, age≥75, and non-non-hypertension subgroups. Higher baseline TSH presented a protective effect on in-hospital all-cause death and HF in patients with AF combined with CAD.