Association between estimated glucose disposal rate and future cardiovascular disease risk across glucose metabolism status: a prospective cohort study

Abstract

Background

Cardiovascular disease (CVD) remains a major global health challenge, particularly affected by glucose metabolism status. However, the relationship between estimated glucose disposal rate (eGDR) and future CVD risk across different glucose metabolism status remains unclear.

Methods

We analyzed data from the China Health and Retirement Longitudinal Study (2011–2020) of participants aged ≥ 45 years. The eGDR was calculated using waist circumference, hypertension status, and HbA1c levels. CVD events (stroke or cardiac events) were the outcome. Participants were categorized by glucose metabolism status (normoglycemia, prediabetes, diabetes). Cox proportional hazards models and restricted cubic splines were used to assess associations and potential non-linear relationships.

Results

Among 7,828 participants (52.84% male, mean age 59.01 ± 9.21 years) followed for an average of 8.29 years, 1,944 participants (24.83%) developed CVD. Higher eGDR was inversely associated with CVD risk across all glucose metabolism states. Below the inflection points (11.77, 11.15, and 11.56 mg/kg/min for normoglycemia, prediabetes, and diabetes, respectively), each 1-unit increase in eGDR reduced CVD risk by 14% (HR = 0.86, 95%CI: 0.83–0.89), 10% (HR = 0.90, 95%CI: 0.86–0.93), and 14% (HR = 0.86, 95%CI: 0.81–0.91), respectively.

Conclusion

The eGDR demonstrates a potentially non-linear inverse association with future CVD risk across different glucose metabolism states.