Maturitas · Oct 21, 2026

Associations of longitudinal patterns of central obesity and chronic low-grade inflammation with incident frailty in middle-aged and older adults

By Chen X, Bu Z, Xu P et al.

BACKGROUND: Frailty is a common geriatric syndrome associated with adverse health outcomes. Although central obesity and chronic low-grade inflammation have both been linked to frailty, their long-term patterns and combined effects remain unclear. METHODS: Data were obtained from 7075 participants in the China Health and Retirement Longitudinal Study. Waist circumference measured in 2011 and 2015 was used to identify longitudinal patterns by K-means clustering, while C-reactive protein levels measured in 2011 and 2015 were classified as low-low, low-high, high-low, and high-high (with 2 mg/L as the threshold between low and high). Frailty was assessed in 2018 and 2020 using the Frailty Index. Logistic regression, cross-lagged analysis, and network analysis were performed. RESULTS: Compared with low waist circumference, high waist circumference was associated with an increased risk of frailty (OR 1.44; 95% CI 1.20-1.72). Compared with the low-low C-reactive protein group, the low-high (OR 1.26; 95% CI 1.07-1.48) and high-high (OR 1.30; 95% CI 1.06-1.59) groups had higher frailty risks. Participants with high waist circumference combined with low-high or high-high C-reactive protein showed the greatest frailty risk. Cross-lagged analysis suggested a stronger temporal association between waist circumference to subsequent changes in level of C-reactive protein, while network analysis identified physical function and disabilities in activities and instrumental activities of daily living as the central frailty components. CONCLUSION: Long-term high waist circumference and persistently or newly elevated C-reactive protein were independently and jointly associated with frailty. These findings highlight the importance of monitoring long-term changes in central obesity and inflammatory status for early identification of individuals at high risk of frailty.

doi.org/10.1016/j.maturitas.2026.109161PubMed 42945651Populations