Estimated glucose disposal rate and risk of cardiovascular disease: evidence from the China Health and Retirement Longitudinal Study

Ren, Xiao; Jiang, Minglan; Han, Longyang; Zheng, Xiaowei

doi:10.1186/s12877-022-03689-x

Cited by 21 publications

(6 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this analysis of the FIDELITY population, the median eGDR (4.1 mg/kg/min) was substantially lower than previous studies of the general population and of patients with type 1 diabetes. For context, the 2022 China Health and Retirement Longitudinal Study, ( N = 8,267; general population), reported a median eGDR of 10.4 mg/kg/min ( 27 ), and two studies of patients with type 1 diabetes ( N ≈ 200 per study) reported mean eGDR of 6.5–10.1 mg/kg/min ( 28 , 29 ). In these studies, low eGDR (high insulin resistance) was defined as those with eGDR <5.39 mg/kg/min in patients with type 1 diabetes ( 28 ) and <8.92 mg/kg/min in the general population ( 27 ).…”

Section: Discussionmentioning

confidence: 99%

“…For context, the 2022 China Health and Retirement Longitudinal Study, ( N = 8,267; general population), reported a median eGDR of 10.4 mg/kg/min ( 27 ), and two studies of patients with type 1 diabetes ( N ≈ 200 per study) reported mean eGDR of 6.5–10.1 mg/kg/min ( 28 , 29 ). In these studies, low eGDR (high insulin resistance) was defined as those with eGDR <5.39 mg/kg/min in patients with type 1 diabetes ( 28 ) and <8.92 mg/kg/min in the general population ( 27 ). In patients with type 1 diabetes, mean eGDR in patients with CKD was significantly lower than in patients without (6.4 vs. 15.9 mg/kg/min; P < 0.001) ( 29 ), which aligns with our results, suggesting a widespread burden of insulin resistance in patients with CKD.…”

Section: Discussionmentioning

confidence: 99%

“…For example, in a cohort study of 104,697 patients with type 2 diabetes from the Swedish National Diabetes Register (2004–2016), low eGDR (<4 mg/kg/min), versus higher eGDR (4 to <8 mg/kg/min), was associated with an increased risk of stroke and CV mortality ( 12 ). Additionally, in the retrospective, population-based China Health and Retirement Longitudinal Study ( N = 8,276), low eGDR was found to be positively correlated with risk of CV disease, stroke, and cardiac events ( 27 ). More recently, Peng et al.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes With Finerenone in Patients With Chronic Kidney Disease and Type 2 Diabetes by Baseline Insulin Resistance

Ebert,

Anker,

Ruilope

et al. 2023

Diabetes Care

View full text Add to dashboard Cite

OBJECTIVE To explore whether insulin resistance, assessed by estimated glucose disposal rate (eGDR), is associated with cardiorenal risk and whether it modifies finerenone efficacy. RESEARCH DESIGN AND METHODS In FIDELITY (N = 13,026), patients with type 2 diabetes, either 1) urine albumin-to-creatinine ratio (UACR) of ≥30 to <300 mg/g and estimated glomerular filtration rate (eGFR) of ≥25 to ≤90 mL/min/1.73 m2 or 2) UACR of ≥300 to ≤5,000 mg/g and eGFR of ≥25 mL/min/1.73 m2, who also received optimized renin-angiotensin system blockade, were randomized to finerenone or placebo. Outcomes included cardiovascular (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure) and kidney (kidney failure, sustained decrease of ≥57% in eGFR from baseline, or renal death) composites. eGDR was calculated using waist circumference, hypertension status, and glycated hemoglobin for 12,964 patients. RESULTS Median eGDR was 4.1 mg/kg/min. eGDR <median (insulin resistant) was associated with higher cardiovascular event incidence regardless of treatment versus ≥median (insulin sensitive) (incidence rate/100 patient-years of 5.18 and 6.34 [for finerenone and placebo] vs. 3.47 and 3.76 [for finerenone and placebo], respectively). However, eGDR was not associated with kidney outcomes. There was no significant heterogeneity for effects of finerenone by eGDR on cardiovascular (<median: hazard ratio [HR] 0.81, 95% CI 0.72–0.92; ≥median: HR = 0.92, 95% CI 0.79–1.06; P interaction = 0.23) or kidney outcomes (<median: HR = 0.84, 95% CI 0.68–1.02; ≥median: HR = 0.70, 95% CI 0.58–0.85; P interaction = 0.28). Overall, finerenone demonstrated similar safety between subgroups. Sensitivity analyses were consistent. CONCLUSIONS Insulin resistance was associated with increased cardiovascular (but not kidney) risk and did not modify finerenone efficacy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes With Finerenone in Patients With Chronic Kidney Disease and Type 2 Diabetes by Baseline Insulin Resistance

Ebert,

Anker,

Ruilope

et al. 2023

Diabetes Care

View full text Add to dashboard Cite

show abstract

“…In comparison to the euglycemic hyperinsulinemic clamp, this technique offers increased accuracy and is suitable for large-scale clinical research (16). Some studies have found that low eGDR is associated with the increased risk of prevalence and poor prognosis in various diseases, such as fatty liver disease, acute coronary syndrome, heart failure and stroke (17)(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

Associations between estimated glucose disposal rate and arterial stiffness and mortality among US adults with non-alcoholic fatty liver disease

Song,

Ma,

Yin

2024

Front. Endocrinol.

View full text Add to dashboard Cite

BackgroundThe estimated glucose disposal rate (eGDR), an effective indicator of insulin resistance, has been related to acute coronary syndrome, ischemic stroke and heart failure. This study aims to explore the relationship between eGDR and arterial stiffness, all-cause mortality and cardiovascular mortality in patients with non-alcoholic fatty liver disease (NAFLD).MethodsParticipants with NAFLD were chosen from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018. The main outcomes are arterial stiffness (represented by estimated pulse wave velocity, ePWV), all-cause and cardiovascular mortality. Multiple cox regression models, restricted cubic spline, sensitivity analysis and subgroup analysis were carried out to investigate the correlation between the insulin resistance indicators and mortality and arterial stiffness. Furthermore, receiver operating characteristic curves were used to compare the predictive value of the eGDR with the triglyceride-glucose (TyG) index and the homeostasis model assessment of insulin resistance (HOMA-IR) for all-cause and cardiovascular mortality.ResultsIn this study, a total of 4,861 participants were included for analysis. After adjusting confounding factors in the multivariate weighted cox regression model, the eGDR was inversely associated with the all-cause mortality (Q4 vs. Q1, HR =0.65 (0.48-0.89, P=0.01) and cardiovascular mortality (Q4 vs. Q1, HR =0.35 (0.19-0.65, P<0.001). Compared with TyG index and HOMA-IR, the eGDR shows excellent predictive value in all-cause mortality (0.588 vs. 0.550 vs. 0.513, P < 0.001) and cardiovascular mortality (0.625 vs. 0.553 vs. 0.537, P < 0.001). In addition, we found a significant negative correlation between eGDR and arterial stiffness (β=-0.13(-0.14–0.11, P< 0.001). However, TyG index and HOMA-IR showed no significant correlation to arterial stiffness.ConclusionsLow eGDR (an indicator of insulin resistance) levels are related to an increased risk of arterial stiffness and mortality in NAFLD patients in the United States.

show abstract

“…A substantial number of the recent studies emphasize the importance of estimated glucose disposal rate (eGDR) for predicting cardio-cerebrovascular events, which indirectly measure the insulin resistance and overall metabolic dysfunctions [1][2][3]. It was reported that an eGDR level less than 8.77 mg/kg/min showed 100% sensitivity and 85.2% specificity for the diagnosis of metabolic syndrome [4,5]. Additionally, lower eGDR is related to micro-vascular complications like retinopathy, nephropathy and neuropathy [6].…”

Section: Introductionmentioning

confidence: 99%

Estimated glucose disposal rate (eGDR) in rural Bangladeshi population and its correlation with cardiometabolic risks

Tomalika

Tagar

Afroz

et al. 2023

IMC Journal of Medical Science

View full text Add to dashboard Cite

Background and objectives: For decades type 2 diabetes mellitus (T2DM) and insulin resistance (IR) are increasingly gaining importance as an underlying mechanism for increased risk of cardiovascular diseases (CVD). IR is related to various cardiometabolic adverse effects. Hyperinsulinemic-euglycemic clamp technique, the gold standard method for measuring IR, is an invasive and complex procedure. Estimation of glucose disposal rate (eGDR) is an easy alternative tool for measuring IR. There is no known study on eGDR level in Bangladeshi native population. Therefore, this study was undertaken to determine the eGDR values in a healthy working rural Bangladeshi population. Materials and methods: Six villages were selected purposively as the study sites. All healthy working people aged ≥20 years in selected rural community were considered eligible. Those who consented to participate in the study were enrolled. Investigations included a) interviewing for social and clinical history, b) anthropometry and measurement of blood pressure and d) estimation of HbA1c and biochemical indices. The eGDR (mg/kg/min) was calculated using formula: eGDR = 21.158 − (0.09 * WC) − (3.407 * HT) − (0.551 * HbA1c); where WC = waist circumference in cm, HT = hypertension (yes = 1/no = 0), and HbA1c = HbA1c (%). Results: A total of 93 (m/w = 29/64) participants were enrolled in the study. The prevalence rates of hypertension, diabetes and metabolic syndrome (MSyn) were 34%, 31.1% and 16.1%, respectively. The mean eGDR value was 9.9 (±0.149; 95% CI: 9.62–10.2) mg/kg/min. Most of the values of biophysical characteristics were normal. The comparison between participants with and without MSyn showed that the former had significantly lower eGDR (9.05±1.24 vs.10.10±1.37, p<0.01). Inverse correlations of eGDR with the obesity, glycemia and lipidemia (weight, waist, FBG, T-chol, and TG) were significant. Declining eGDR were significant with rising WHR, WHtR, TG/HDLR and T-chol/HDLR (for all, p<0.05). Conclusions: The study revealed the level of eGDR in a healthy working people of a rural community of Bangladesh. Moreover, eGDR was found to decrease significantly with the increasing cardiometabolic risks. The study revealed a higher prevalence of hypertension, diabetes and metabolic syndrome in apparently healthy working people highlighting susceptibility of Bangladeshi natives to non-communicable diseases. IMC J Med Sci. 2023; 17(2):005. DOI: https://doi.org/10.55010/imcjms.17.015 *Correspondence: M Abu Sayeed, Department of Community Medicine, Ibrahim Medical College, 1/A, Ibrahim Sarani, Segunbagicha, Dhaka 1000, Bangladesh. Email: sayeed1950@gmail.com

show abstract

Estimated glucose disposal rate and risk of cardiovascular disease: evidence from the China Health and Retirement Longitudinal Study

Cited by 21 publications

References 36 publications

Outcomes With Finerenone in Patients With Chronic Kidney Disease and Type 2 Diabetes by Baseline Insulin Resistance

Outcomes With Finerenone in Patients With Chronic Kidney Disease and Type 2 Diabetes by Baseline Insulin Resistance

Associations between estimated glucose disposal rate and arterial stiffness and mortality among US adults with non-alcoholic fatty liver disease

Estimated glucose disposal rate (eGDR) in rural Bangladeshi population and its correlation with cardiometabolic risks

Contact Info

Product

Resources

About