Scholarlink

Background <p>The estimated glucose disposal rate (eGDR), calculated from glycated hemoglobin (HbA1c), hypertension status and BMI, is a proxy for insulin resistance. We examined the association between eGDR and the risk of first myocardial infarction (MI) and post-MI mortality in individuals with type 1 and type 2 diabetes.</p> Methods <p>Using nationwide health registry data (2006–2020), we identified individuals with type 1 and type 2 diabetes. Follow-up started at the first time a complete eGDR could be calculated. eGDR was then handled as a time-updated exposure until first MI, with person-time assigned according to the most recent available value. Among those with MI, follow-up for post-MI mortality started at the event, and covariates were fixed at their last value before MI. Hazard ratios (HRs) with 95% CIs were estimated using Cox regression with adjustment for blood lipids, albuminuria, estimated glomerular filtration rate and physical activity.</p> Results <p>We included 46,155 individuals with type 1 diabetes and 570,230 individuals with type 2 diabetes (both 43% women). During a median follow up of 7.7 person-years, 1997 (4.3%) and 34,237 (6.0%) experienced first MI, respectively. Adjusted HRs (95% CIs) for first MI across eGDR categories ≤4, 4–6, 6–8, and ≥8&#xa0;mg/kg/min) were: 3.73 (3.35–4.16), 3.09 (2.85–3.35), 2.40 (2.15–2.69) and 0.96 (0.79–1.17) for type 1 diabetes, respectively. Corresponding HRs for type 2 diabetes were 1.71 (1.62–1.82), 1.54 (1.46–1.62), 1.43 (1.35–1.51) and 1 (reference). Similar associations were observed for post-MI mortality, however non-significant across all eGDR categories.</p> Conclusions <p>Lower eGDR, reflecting greater insulin resistance, was associated with a higher risk of first MI, with a stronger association observed in type 1 diabetes. These findings support insulin resistance as a potential modifiable cardiovascular risk factor in people with diabetes.</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

Estimated glucose disposal rate and risk of first myocardial infarction in people with diabetes

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月25日

查看全文
  • Linn Glynn,
  • Martina Persson,
  • Tomas Andersson,
  • Robin Hofmann,
  • Thomas Nyström

摘要

Background

The estimated glucose disposal rate (eGDR), calculated from glycated hemoglobin (HbA1c), hypertension status and BMI, is a proxy for insulin resistance. We examined the association between eGDR and the risk of first myocardial infarction (MI) and post-MI mortality in individuals with type 1 and type 2 diabetes.

Methods

Using nationwide health registry data (2006–2020), we identified individuals with type 1 and type 2 diabetes. Follow-up started at the first time a complete eGDR could be calculated. eGDR was then handled as a time-updated exposure until first MI, with person-time assigned according to the most recent available value. Among those with MI, follow-up for post-MI mortality started at the event, and covariates were fixed at their last value before MI. Hazard ratios (HRs) with 95% CIs were estimated using Cox regression with adjustment for blood lipids, albuminuria, estimated glomerular filtration rate and physical activity.

Results

We included 46,155 individuals with type 1 diabetes and 570,230 individuals with type 2 diabetes (both 43% women). During a median follow up of 7.7 person-years, 1997 (4.3%) and 34,237 (6.0%) experienced first MI, respectively. Adjusted HRs (95% CIs) for first MI across eGDR categories ≤4, 4–6, 6–8, and ≥8 mg/kg/min) were: 3.73 (3.35–4.16), 3.09 (2.85–3.35), 2.40 (2.15–2.69) and 0.96 (0.79–1.17) for type 1 diabetes, respectively. Corresponding HRs for type 2 diabetes were 1.71 (1.62–1.82), 1.54 (1.46–1.62), 1.43 (1.35–1.51) and 1 (reference). Similar associations were observed for post-MI mortality, however non-significant across all eGDR categories.

Conclusions

Lower eGDR, reflecting greater insulin resistance, was associated with a higher risk of first MI, with a stronger association observed in type 1 diabetes. These findings support insulin resistance as a potential modifiable cardiovascular risk factor in people with diabetes.

Graphical Abstract