{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T08:21:11Z","timestamp":1793866871499,"version":"4.6.1"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Estimated glucose disposal rate (eGDR) is a simple and effective measure for insulin resistance, which is associated with higher risk of frailty. We aim to analyse the associations of eGDR with frailty risk and its reversibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A population\u2010based longitudinal study was conducted of 11\u2009670 participants from the China Health and Retirement Longitudinal Study and 19\u2009355 participants from the Health and Retirement Study. Frailty was assessed by the frailty index and reversibility was measured by transitions from frailty at baseline to non\u2010frailty during follow\u2010up. The eGDR was divided into Q\n                      <jats:sub>1<\/jats:sub>\n                      , Q\n                      <jats:sub>2<\/jats:sub>\n                      , Q\n                      <jats:sub>3<\/jats:sub>\n                      and Q\n                      <jats:sub>4<\/jats:sub>\n                      according to the quartiles. Multi\u2010state Markov model was performed to evaluate the effects of eGDR on transitions among non\u2010frailty, frailty and death. Cox regression model was used to estimate eGDR associated with the risk of frailty and the likelihood of reversion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In Chinese population characterized by a median age of 60\u2009years (IQR: 54\u201366) with 6119 women (52.43%), compared with the Q\n                      <jats:sub>1<\/jats:sub>\n                      level of eGDR, participants exposure to Q\n                      <jats:sub>3<\/jats:sub>\n                      and Q\n                      <jats:sub>4<\/jats:sub>\n                      level decreased the probability of transitioning from non\u2010frailty to frailty by 22% (HR\u2009=\u20090.78, 95% CI: 0.69\u20130.88) and 25% (HR\u2009=\u20090.75, 95% CI: 0.66\u20130.86), respectively. But its Q\n                      <jats:sub>2<\/jats:sub>\n                      , Q\n                      <jats:sub>3<\/jats:sub>\n                      and Q\n                      <jats:sub>4<\/jats:sub>\n                      levels increased the probability of transitioning from frailty to non\u2010frailty by 24% (HR\u2009=\u20091.24, 95% CI: 1.06\u20131.44), 39% (HR\u2009=\u20091.39, 95% CI: 1.19\u20131.64) and 33% (HR\u2009=\u20091.33, 95% CI: 1.13\u20131.58). In American population with a median age of 63\u2009years (IQR: 56\u201372) and 11\u2009189 women (57.81%), its Q\n                      <jats:sub>2<\/jats:sub>\n                      , Q\n                      <jats:sub>3<\/jats:sub>\n                      and Q\n                      <jats:sub>4<\/jats:sub>\n                      levels decreased the probability of transitioning from non\u2010frailty to frailty by 17% (HR\u2009=\u20090.83, 95% CI: 0.77\u20130.89), 24% (HR\u2009=\u20090.76, 95% CI: 0.70\u20130.82) and 46% (HR\u2009=\u20090.54, 95% CI: 0.49\u20130.59), respectively. The probability of revising frailty increased by 25% (HR\u2009=\u20091.25, 95% CI: 1.13\u20131.38), 36% (HR\u2009=\u20091.36, 95% CI: 1.22\u20131.51) and 48% (HR\u2009=\u20091.48, 95% CI: 1.30\u20131.69) for levels Q\n                      <jats:sub>2<\/jats:sub>\n                      , Q\n                      <jats:sub>3<\/jats:sub>\n                      and Q\n                      <jats:sub>4<\/jats:sub>\n                      . As shown in the prospective analysis, increased eGDR levels from Q\n                      <jats:sub>2<\/jats:sub>\n                      to Q\n                      <jats:sub>4<\/jats:sub>\n                      were associated with decreased frailty risk and higher likelihood of reversion, as evidenced by the dose\u2013response relationship revealed by restricted cubic spline analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher levels of eGDR were associated with a reduced risk of frailty, delayed transition from non\u2010frailty to frailty and an increased likelihood of reversion. eGDR emerges as a promising predictor for early frailty detection, prognosis assessment and a potential therapeutic target for intervention strategies.<\/jats:p>\n                  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