Scholarlink

Background <p>Insulin resistance has been widely recognized as an independent risk factor for cardiovascular diseases and diabetes. The estimated glucose disposal rate (eGDR) is a well-established surrogate marker of insulin sensitivity; however, limited evidence exists regarding the dynamic changes of eGDR and their association with cardiometabolic multimorbidity. This study aimed to evaluate the associations of cumulative eGDR and eGDR change with the risk of cardiometabolic multimorbidity in middle-aged and older adults.</p> Methods <p>This prospective cohort study included 4059 participants from the China Health and Retirement Longitudinal Study (CHARLS) who were free of cardiovascular disease and diabetes at baseline. Groups of eGDR change were identified using K-means clustering method based on eGDR values at two time points. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident cardiometabolic multimorbidity.</p> Results <p>During a median follow-up of 9.0 years, 843 (20.8%) participants developed cardiometabolic multimorbidity. Compared with the highest quartile of cumulative eGDR, the lowest quartile was significantly associated with a 1.67-fold increased risk of cardiometabolic multimorbidity (HR: 1.67; 95% CI 1.34–2.08; <i>P</i> &lt; 0.001) after adjusting for potential confounders. Four distinct eGDR change groups were identified: consistent high, consistent moderate, consistent low, and moderate-low. Compared with the consistent high group, the moderate-low group showed the highest risk of cardiometabolic multimorbidity (HR: 1.64; 95% CI 1.30–2.06; <i>P</i> &lt; 0.001), followed by consistent low group (HR: 1.62; 95% CI 1.32–1.99; <i>P</i> &lt; 0.001) and consistent moderate group (HR: 1.26; 95% CI 1.04–1.53; <i>P</i> = 0.017).</p> Conclusions <p>Cumulative eGDR and eGDR change were independently associated with increased risk of cardiometabolic multimorbidity in middle-aged and older adults. These findings highlight the importance of monitoring longitudinal eGDR change for early identification of individuals at high risk of cardiometabolic multimorbidity.</p> Graphical abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Changes in the estimated glucose disposal rate and cardiometabolic multimorbidity in middle-aged and older adults

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月27日

查看全文
  • Cancan Cui,
  • Te Zhang,
  • Jiannan Li,
  • Fenghe Shi,
  • Jinghui Cao,
  • Shixiang Zhao,
  • Huanlin Liu,
  • Zixin Zhang,
  • Yanxi Liu,
  • Lin Liu,
  • Jianshi Du

摘要

Background

Insulin resistance has been widely recognized as an independent risk factor for cardiovascular diseases and diabetes. The estimated glucose disposal rate (eGDR) is a well-established surrogate marker of insulin sensitivity; however, limited evidence exists regarding the dynamic changes of eGDR and their association with cardiometabolic multimorbidity. This study aimed to evaluate the associations of cumulative eGDR and eGDR change with the risk of cardiometabolic multimorbidity in middle-aged and older adults.

Methods

This prospective cohort study included 4059 participants from the China Health and Retirement Longitudinal Study (CHARLS) who were free of cardiovascular disease and diabetes at baseline. Groups of eGDR change were identified using K-means clustering method based on eGDR values at two time points. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident cardiometabolic multimorbidity.

Results

During a median follow-up of 9.0 years, 843 (20.8%) participants developed cardiometabolic multimorbidity. Compared with the highest quartile of cumulative eGDR, the lowest quartile was significantly associated with a 1.67-fold increased risk of cardiometabolic multimorbidity (HR: 1.67; 95% CI 1.34–2.08; P < 0.001) after adjusting for potential confounders. Four distinct eGDR change groups were identified: consistent high, consistent moderate, consistent low, and moderate-low. Compared with the consistent high group, the moderate-low group showed the highest risk of cardiometabolic multimorbidity (HR: 1.64; 95% CI 1.30–2.06; P < 0.001), followed by consistent low group (HR: 1.62; 95% CI 1.32–1.99; P < 0.001) and consistent moderate group (HR: 1.26; 95% CI 1.04–1.53; P = 0.017).

Conclusions

Cumulative eGDR and eGDR change were independently associated with increased risk of cardiometabolic multimorbidity in middle-aged and older adults. These findings highlight the importance of monitoring longitudinal eGDR change for early identification of individuals at high risk of cardiometabolic multimorbidity.

Graphical abstract