Associations of the Neutrophil-to-Lymphocyte Ratio(NLR), Triglyceride-Glucose Index (TyG), and TyG-derived indices with vitality decline in older adults in China: a study within the Integrated Care for Older People (ICOPE) framework
Abstract Background/Objectives Aging populations have led to numerous health challenges. The World Health Organization (WHO) proposed "Healthy Aging" to promote elderly health by optimizing Intrinsic Capacity (IC) with vitality as a core component of metabolic homeostasis. The relationship...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-07-01
|
| Series: | Lipids in Health and Disease |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12944-025-02671-x |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849332323739238400 |
|---|---|
| author | Jiaxiu Zhao Xueying Ji Yixin Chen Jiaofeng Wang Jie Chen Yiqin Huang Zhijun Bao |
| author_facet | Jiaxiu Zhao Xueying Ji Yixin Chen Jiaofeng Wang Jie Chen Yiqin Huang Zhijun Bao |
| author_sort | Jiaxiu Zhao |
| collection | DOAJ |
| description | Abstract Background/Objectives Aging populations have led to numerous health challenges. The World Health Organization (WHO) proposed "Healthy Aging" to promote elderly health by optimizing Intrinsic Capacity (IC) with vitality as a core component of metabolic homeostasis. The relationships between vitality decline and inflammatory-metabolic indicators (the NLR and TyG index) remain to be investigated. Methods This study recruited 986 community-dwelling adults ≥ 60 years old at the Beixingjing Street Community from March 25, 2024, to June 17, 2024, in Shanghai, China. Participants underwent comprehensive face‒to-face assessments with IC evaluations conducted according to the Integrated Care for Older People (ICOPE) guidelines. Vitality was evaluated using the Mini Nutritional Assessment-Short Form (MNA-SF). The study population was divided into two groups based on vitality decline (scores < 12). Multivariable logistic regression was used to analyze associations between vitality decline and other IC domains as well as between vitality decline and inflammatory (NLR) and metabolic indices (TyG, TyG-WC, TyG-BMI, and TyG-WHtR). Three logistic regression models constructed with progressive adjustments were used to assess associations between indices (NLR, TyG, TyG-WC, TyG-BMI, and TyG-WHtR) and vitality decline. Restricted cubic spline (RCS) analyses explored potential nonlinear relationships and threshold effects. Receiver Operating Characteristic (ROC) curve analysis was used to assess the discriminative capacity of different models. Results The prevalence of vitality decline was 16.43%. Vitality decline was strongly associated with psychological and locomotor capacity decline in fully adjusted models (p < 0.05). An elevated NLR showed a significant association with greater vitality decline (OR = 1.233, p = 0.045). Participants in the highest NLR quartile (Q4) demonstrated significantly greater odds of vitality decline compared to those in the lowest quartile (Q1) (OR = 1.886, p = 0.043). Conversely, unit increases in TyG-derived indices demonstrated protective effects as follows: TyG-WC (OR = 0.988, p < 0.001), TyG-BMI (OR = 0.952, p < 0.001) and TyG-WHtR (OR = 0.120, p < 0.001). In contrast, TyG alone did not reach statistical significance (OR = 0.622, p = 0.078). The highest-quartile (Q4) participants presented a significantly lower risk of vitality decline than the lowest-quartile (Q1) participants as follows: TyG-WC (OR = 0.104, p < 0.001), TyG-BMI (OR = 0.052, p < 0.001), and TyG-WHtR (OR = 0.070, p < 0.001). Interaction terms between NLR, TyG and its indicators were analyzed in separate models and across quartiles. These terms did not show consistent significant associations with vitality decline. RCS analysis with vitality decline as the dependent variable identified threshold effects at TyG-WC = 794.358, TyG-BMI = 209.179, and TyG-WHtR = 4.476. The analysis revealed significant positive linear relationships between NLR and vitality decline, negative linear relationships between TyG and vitality decline, and negative nonlinear relationships between TyG-derived indices and vitality decline. Sensitivity analyses using MNA-SF score as a continuous variable confirmed similar relationship patterns, with NLR showing a significant linear negative association with MNA-SF score and TyG showing a linear positive association. The TyG-derived indices exhibited significant positive nonlinear relationships with MNA-SF scores, with threshold effects emerging at TyG-WC = 666.818, TyG-BMI = 210.997, and TyG-WHtR = 4.405. Effect sizes below the inflection points were substantially larger than those above thresholds, suggesting more pronounced effects at lower values. Among all biomarkers examined, NLR demonstrated the strongest association with vitality decline (AUC = 0.873). Subgroup analyses revealed significant effect modifications exclusively for TyG-derived indices but not for NLR or TyG alone. Conclusions This study revealed a high prevalence of vitality decline among older Chinese adults, which was strongly associated with a decrease in psychological and locomotor capacity. NLR showed a negative linear correlation with vitality, whereas TyG-derived parameters showed nonlinear positive associations with a plateau effect. NLR showed optimal discriminative capacity among all indicators for identifying vitality decline. |
| format | Article |
| id | doaj-art-a62c6d82d3ae444b943ea87f6609a36a |
| institution | Kabale University |
| issn | 1476-511X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Lipids in Health and Disease |
| spelling | doaj-art-a62c6d82d3ae444b943ea87f6609a36a2025-08-20T03:46:13ZengBMCLipids in Health and Disease1476-511X2025-07-0124111910.1186/s12944-025-02671-xAssociations of the Neutrophil-to-Lymphocyte Ratio(NLR), Triglyceride-Glucose Index (TyG), and TyG-derived indices with vitality decline in older adults in China: a study within the Integrated Care for Older People (ICOPE) frameworkJiaxiu Zhao0Xueying Ji1Yixin Chen2Jiaofeng Wang3Jie Chen4Yiqin Huang5Zhijun Bao6Department of Gerontology, Huadong Hospital, Shanghai Medical College, Fudan UniversityDepartment of General Practice, Huadong Hospital, Shanghai Medical College, Fudan UniversityDepartment of Gerontology, Huadong Hospital, Shanghai Medical College, Fudan UniversityDepartment of Gerontology, Huadong Hospital, Shanghai Medical College, Fudan UniversityDepartment of Gerontology, Huadong Hospital, Shanghai Medical College, Fudan UniversityDepartment of General Practice, Huadong Hospital, Shanghai Medical College, Fudan UniversityDepartment of Gerontology, Huadong Hospital, Shanghai Medical College, Fudan UniversityAbstract Background/Objectives Aging populations have led to numerous health challenges. The World Health Organization (WHO) proposed "Healthy Aging" to promote elderly health by optimizing Intrinsic Capacity (IC) with vitality as a core component of metabolic homeostasis. The relationships between vitality decline and inflammatory-metabolic indicators (the NLR and TyG index) remain to be investigated. Methods This study recruited 986 community-dwelling adults ≥ 60 years old at the Beixingjing Street Community from March 25, 2024, to June 17, 2024, in Shanghai, China. Participants underwent comprehensive face‒to-face assessments with IC evaluations conducted according to the Integrated Care for Older People (ICOPE) guidelines. Vitality was evaluated using the Mini Nutritional Assessment-Short Form (MNA-SF). The study population was divided into two groups based on vitality decline (scores < 12). Multivariable logistic regression was used to analyze associations between vitality decline and other IC domains as well as between vitality decline and inflammatory (NLR) and metabolic indices (TyG, TyG-WC, TyG-BMI, and TyG-WHtR). Three logistic regression models constructed with progressive adjustments were used to assess associations between indices (NLR, TyG, TyG-WC, TyG-BMI, and TyG-WHtR) and vitality decline. Restricted cubic spline (RCS) analyses explored potential nonlinear relationships and threshold effects. Receiver Operating Characteristic (ROC) curve analysis was used to assess the discriminative capacity of different models. Results The prevalence of vitality decline was 16.43%. Vitality decline was strongly associated with psychological and locomotor capacity decline in fully adjusted models (p < 0.05). An elevated NLR showed a significant association with greater vitality decline (OR = 1.233, p = 0.045). Participants in the highest NLR quartile (Q4) demonstrated significantly greater odds of vitality decline compared to those in the lowest quartile (Q1) (OR = 1.886, p = 0.043). Conversely, unit increases in TyG-derived indices demonstrated protective effects as follows: TyG-WC (OR = 0.988, p < 0.001), TyG-BMI (OR = 0.952, p < 0.001) and TyG-WHtR (OR = 0.120, p < 0.001). In contrast, TyG alone did not reach statistical significance (OR = 0.622, p = 0.078). The highest-quartile (Q4) participants presented a significantly lower risk of vitality decline than the lowest-quartile (Q1) participants as follows: TyG-WC (OR = 0.104, p < 0.001), TyG-BMI (OR = 0.052, p < 0.001), and TyG-WHtR (OR = 0.070, p < 0.001). Interaction terms between NLR, TyG and its indicators were analyzed in separate models and across quartiles. These terms did not show consistent significant associations with vitality decline. RCS analysis with vitality decline as the dependent variable identified threshold effects at TyG-WC = 794.358, TyG-BMI = 209.179, and TyG-WHtR = 4.476. The analysis revealed significant positive linear relationships between NLR and vitality decline, negative linear relationships between TyG and vitality decline, and negative nonlinear relationships between TyG-derived indices and vitality decline. Sensitivity analyses using MNA-SF score as a continuous variable confirmed similar relationship patterns, with NLR showing a significant linear negative association with MNA-SF score and TyG showing a linear positive association. The TyG-derived indices exhibited significant positive nonlinear relationships with MNA-SF scores, with threshold effects emerging at TyG-WC = 666.818, TyG-BMI = 210.997, and TyG-WHtR = 4.405. Effect sizes below the inflection points were substantially larger than those above thresholds, suggesting more pronounced effects at lower values. Among all biomarkers examined, NLR demonstrated the strongest association with vitality decline (AUC = 0.873). Subgroup analyses revealed significant effect modifications exclusively for TyG-derived indices but not for NLR or TyG alone. Conclusions This study revealed a high prevalence of vitality decline among older Chinese adults, which was strongly associated with a decrease in psychological and locomotor capacity. NLR showed a negative linear correlation with vitality, whereas TyG-derived parameters showed nonlinear positive associations with a plateau effect. NLR showed optimal discriminative capacity among all indicators for identifying vitality decline.https://doi.org/10.1186/s12944-025-02671-xOlder adultsICOPEVitality declineNLRTyGIntrinsic capacity |
| spellingShingle | Jiaxiu Zhao Xueying Ji Yixin Chen Jiaofeng Wang Jie Chen Yiqin Huang Zhijun Bao Associations of the Neutrophil-to-Lymphocyte Ratio(NLR), Triglyceride-Glucose Index (TyG), and TyG-derived indices with vitality decline in older adults in China: a study within the Integrated Care for Older People (ICOPE) framework Lipids in Health and Disease Older adults ICOPE Vitality decline NLR TyG Intrinsic capacity |
| title | Associations of the Neutrophil-to-Lymphocyte Ratio(NLR), Triglyceride-Glucose Index (TyG), and TyG-derived indices with vitality decline in older adults in China: a study within the Integrated Care for Older People (ICOPE) framework |
| title_full | Associations of the Neutrophil-to-Lymphocyte Ratio(NLR), Triglyceride-Glucose Index (TyG), and TyG-derived indices with vitality decline in older adults in China: a study within the Integrated Care for Older People (ICOPE) framework |
| title_fullStr | Associations of the Neutrophil-to-Lymphocyte Ratio(NLR), Triglyceride-Glucose Index (TyG), and TyG-derived indices with vitality decline in older adults in China: a study within the Integrated Care for Older People (ICOPE) framework |
| title_full_unstemmed | Associations of the Neutrophil-to-Lymphocyte Ratio(NLR), Triglyceride-Glucose Index (TyG), and TyG-derived indices with vitality decline in older adults in China: a study within the Integrated Care for Older People (ICOPE) framework |
| title_short | Associations of the Neutrophil-to-Lymphocyte Ratio(NLR), Triglyceride-Glucose Index (TyG), and TyG-derived indices with vitality decline in older adults in China: a study within the Integrated Care for Older People (ICOPE) framework |
| title_sort | associations of the neutrophil to lymphocyte ratio nlr triglyceride glucose index tyg and tyg derived indices with vitality decline in older adults in china a study within the integrated care for older people icope framework |
| topic | Older adults ICOPE Vitality decline NLR TyG Intrinsic capacity |
| url | https://doi.org/10.1186/s12944-025-02671-x |
| work_keys_str_mv | AT jiaxiuzhao associationsoftheneutrophiltolymphocyterationlrtriglycerideglucoseindextygandtygderivedindiceswithvitalitydeclineinolderadultsinchinaastudywithintheintegratedcareforolderpeopleicopeframework AT xueyingji associationsoftheneutrophiltolymphocyterationlrtriglycerideglucoseindextygandtygderivedindiceswithvitalitydeclineinolderadultsinchinaastudywithintheintegratedcareforolderpeopleicopeframework AT yixinchen associationsoftheneutrophiltolymphocyterationlrtriglycerideglucoseindextygandtygderivedindiceswithvitalitydeclineinolderadultsinchinaastudywithintheintegratedcareforolderpeopleicopeframework AT jiaofengwang associationsoftheneutrophiltolymphocyterationlrtriglycerideglucoseindextygandtygderivedindiceswithvitalitydeclineinolderadultsinchinaastudywithintheintegratedcareforolderpeopleicopeframework AT jiechen associationsoftheneutrophiltolymphocyterationlrtriglycerideglucoseindextygandtygderivedindiceswithvitalitydeclineinolderadultsinchinaastudywithintheintegratedcareforolderpeopleicopeframework AT yiqinhuang associationsoftheneutrophiltolymphocyterationlrtriglycerideglucoseindextygandtygderivedindiceswithvitalitydeclineinolderadultsinchinaastudywithintheintegratedcareforolderpeopleicopeframework AT zhijunbao associationsoftheneutrophiltolymphocyterationlrtriglycerideglucoseindextygandtygderivedindiceswithvitalitydeclineinolderadultsinchinaastudywithintheintegratedcareforolderpeopleicopeframework |