The liver contribution to the biological network underlying physical frailty in aging is underestimated. How best to measure this contribution magnitude and impact on health risk trajectories in frail individuals is not yet entirely clear. We analyzed the association of a novel liver frailty phenotype with the risk of death in older participants of the Salus in Apulia Study cohort. Clinical and physical examination, routine biomarkers, medical history, and anthropometry were analyzed in 1929 older adults (65 +). Physical frailty was classified by Cardiovascular Health Study criteria, and liver fibrosis risk by fibrosis-4 (FIB-4). The liver frailty phenotype was defined as physical frailty plus high-risk liver fibrosis (score > 2.67). Physical frailty, high-risk liver fibrosis, and liver frailty subjects were compared to subjects without these conditions (non-frail). Proportional Cox regression tested the adjusted association between liver frailty and all-cause mortality for each category. The liver frailty prevalence was relatively low (3.8%), but higher in men (58.1%). Compared to non-frail older subjects, liver frailty subjects were significantly older (effect size (ES) − 1.11, 95% confidence interval (CI) − 1.35 to − 0.87), with a lower education (ES 0.48, 95%CI 0.24 to 0.71) and higher multimorbidity (ES 15.81, 95%CI 4.20 to 27.41). Cox multivariate analyses showed a two-fold increased risk of overall mortality (hazard ratio 2.09, 95%CI 1.16–3.74) even after the adjustment for age, sex, education, and alcohol consumption. The liver frailty phenotype runs twice the risk of overall mortality compared with the non-frail population. This clinical tool, validated in a Southern Italian population, is based on simple sets of measures that can conveniently be assessed also in the primary care setting.

肝脏对衰老过程中身体虚弱的生物网络的贡献被低估了。如何最好地衡量这种贡献程度以及对体弱个体健康风险轨迹的影响尚不完全清楚。我们分析了阿普利亚 Salus 研究队列中老年参与者的新型肝衰弱表型与死亡风险之间的关系。对 1929 名老年人（65 岁以上）的临床和体格检查、常规生物标志物、病史和人体测量学进行了分析。身体虚弱按心血管健康研究标准分类，肝纤维化风险按 fibrosis-4 (FIB-4) 分类。肝衰弱表型被定义为身体衰弱加上高危肝纤维化（评分> 2.67）。身体虚弱，高危肝纤维化，肝虚弱的受试者与没有这些情况的受试者（非虚弱）进行了比较。比例 Cox 回归测试了每个类别的肝衰弱和全因死亡率之间的调整关联。肝衰患病率相对较低（3.8%），但男性较高（58.1%）。与非体弱的老年受试者相比，肝功能虚弱的受试者年龄显着增加（效应大小 (ES) - 1.11, 95% 置信区间 (CI) - 1.35 至 - 0.87），受教育程度较低（ES 0.48, 95%CI 0.24 至0.71）和更高的多发病率（ES 15.81, 95%CI 4.20 至 27.41）。Cox 多变量分析显示，即使在调整了年龄、性别、教育程度和饮酒量后，总死亡率的风险也增加了两倍（风险比 2.09，95%CI 1.16-3.74）。与非虚弱人群相比，肝脏虚弱表型的总体死亡风险是其两倍。这种在意大利南部人群中验证的临床工具基于简单的措施集，这些措施也可以在初级保健环境中方便地进行评估。