Insulin resistance assessed by estimated glucose disposal rate and risk of atherosclerotic cardiovascular diseases incidence: the multi-ethnic study of atherosclerosis.

IF 8.5 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Diabetology Pub Date : 2024-09-28 DOI:10.1186/s12933-024-02437-2

Jiayi Yi, Chao Qu, Xiang Li, Hai Gao

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引用次数: 0

Abstract

Background: To investigate the relationship between estimated glucose disposal rate (eGDR), a surrogate indicator of insulin resistance, and atherosclerotic cardiovascular diseases (ASCVD) incidence risk.

Methods: This prospective cohort study utilized data from the 6026 participants from the Multi-Ethnic Study of Atherosclerosis. The eGDR (mg/kg/min) was computed as 21.158 - (0.09 × waist circumference [cm]) - (3.407 × hypertension [yes/no]) - (0.551 × HbA1c [%]). The population was categorized into four subgroups according to the quartiles (Q) of eGDR. Cox proportional hazard models were applied to assess the associations between eGDR and ASCVD incidence, and restricted cubic spine (RCS) was employed to examine the dose-response relationship.

Results: The mean age of participants was 63.6 ± 10.1 years, comprising 3163 (52.5%) women. Over a median follow-up duration of 14.1 years, 565 (9.4%) developed ASCVD, including 256 (4.2%) myocardial infarctions, 234 (3.9%) strokes, and 358 (5.9%) fatal coronary heart disease. Compared to the lowest quartile, the adjusted hazard ratios (95% confidence intervals) for incident ASCVD for Q2-Q4 were 0.87 (0.68-1.10), 0.63 (0.47-0.84), and 0.43 (0.30-0.64), respectively. Per 1 standard deviation increase in eGDR was associated with a 30% (HR: 0.70, 95% CI 0.60-0.80) risk reduction of ASCVD, with the subgroup analyses indicating that age and hypertension modified the association (P for interaction < 0.05). RCS analysis indicated a significant and linear relationship between eGDR and ASCVD incidence risk.

Conclusion: eGDR level was negatively associated with incident ASCVD risk in a linear fashion among the general population. Our findings may contribute to preventive measures by improving ASCVD risk assessment.

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通过估计葡萄糖处置率评估胰岛素抵抗与动脉粥样硬化性心血管疾病发病风险：动脉粥样硬化多种族研究。

背景：目的：研究作为胰岛素抵抗替代指标的估计葡萄糖排泄率（eGDR）与动脉粥样硬化性心血管疾病（ASCVD）发病风险之间的关系：这项前瞻性队列研究利用了多种族动脉粥样硬化研究（Multi-Ethnic Study of Atherosclerosis）6026 名参与者的数据。eGDR (mg/kg/min) 的计算公式为 21.158 - (0.09 × 腰围 [cm]) - (3.407 × 高血压 [是/否]) - (0.551 × HbA1c [%])。根据 eGDR 的四分位数 (Q) 将人群分为四个亚组。采用Cox比例危险模型评估eGDR与ASCVD发病率之间的关系，并采用限制性立方体脊柱（RCS）检验剂量-反应关系：参与者的平均年龄为 63.6 ± 10.1 岁，其中女性 3163 人（52.5%）。在14.1年的中位随访期间，565人（9.4%）患上了ASCVD，包括256人（4.2%）心肌梗死、234人（3.9%）中风和358人（5.9%）致命性冠心病。与最低四分位数相比，Q2-Q4发生ASCVD的调整危险比（95%置信区间）分别为0.87（0.68-1.10）、0.63（0.47-0.84）和0.43（0.30-0.64）。eGDR每增加1个标准差，ASCVD风险就会降低30%（HR：0.70，95% CI 0.60-0.80），亚组分析表明，年龄和高血压会改变这种关联（P为交互作用结论：在普通人群中，eGDR水平与ASCVD发病风险呈线性负相关。我们的研究结果可能有助于通过改进 ASCVD 风险评估来采取预防措施。

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来源期刊

Cardiovascular Diabetology 医学-内分泌学与代谢

CiteScore

12.30

自引率

15.10%

发文量

240

审稿时长

1 months

期刊介绍： Cardiovascular Diabetology is a journal that welcomes manuscripts exploring various aspects of the relationship between diabetes, cardiovascular health, and the metabolic syndrome. We invite submissions related to clinical studies, genetic investigations, experimental research, pharmacological studies, epidemiological analyses, and molecular biology research in this field.