Associations of Estimated Glucose Disposal Rate With Stroke Risk and Poststroke Adverse Outcomes: A Prospective Cohort Study

IF 5 1区医学 Q1 NEUROSCIENCES

CNS Neuroscience & Therapeutics Pub Date : 2025-06-05 DOI:10.1111/cns.70420

Xiaxuan Huang, Peina Dong, Yixian Xu, Yitong Ling, Shanyuan Tan, Zihong Bai, Si Shen, Jun Lyu, Hao Wang

{"title":"Associations of Estimated Glucose Disposal Rate With Stroke Risk and Poststroke Adverse Outcomes: A Prospective Cohort Study","authors":"Xiaxuan Huang, Peina Dong, Yixian Xu, Yitong Ling, Shanyuan Tan, Zihong Bai, Si Shen, Jun Lyu, Hao Wang","doi":"10.1111/cns.70420","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims</h3>\n \n <p>This study investigated the relationship between estimated glucose disposal rate (eGDR), a validated marker of insulin resistance, and stroke subtypes and poststroke outcomes. Despite eGDR's established role in predicting cardiovascular outcomes, its impact on stroke risk and prognosis has not been fully explored.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This study included 462,550 participants from the UK Biobank with eGDR assessments, and participants were stratified into three categories based on tertiles of eGDR. The primary outcomes were stroke and its subtypes (ischemic and hemorrhagic stroke). Cox proportional hazard models and restricted cubic spline regression were used to analyze associations between eGDR and outcomes. Secondary analyses investigated poststroke adverse events (depression, disability, epilepsy, and delirium). Mediation analyses were conducted to explore the underlying mechanisms driven by inflammatory markers, eGDR, and stroke.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>During a median follow-up of 13.9 years, 12,325 stroke cases were recorded. Compared to the lowest eGDR tertile (< 6.525 mg/kg/min), individuals in the highest tertile (> 8.494 mg/kg/min) demonstrated a significantly reduced risk of stroke (HR = 0.53, 95% CI: 0.50–0.56), particularly ischemic stroke (HR = 0.53, 95% CI: 0.50–0.57). Higher eGDR levels were also associated with a decreased risk of poststroke adverse outcomes (HR = 0.83, 95% CI: 0.73–0.94), with similar risk estimates observed for depression, disability, epilepsy, and delirium. Furthermore, inflammatory markers partially mediated the relationship between eGDR and stroke risk.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Elevated eGDR levels were associated with decreased risks of stroke and poststroke adverse outcomes. These findings suggest improving insulin sensitivity, as reflected by higher eGDR, maybe a potential therapeutic target for stroke prevention or stroke rehabilitation.</p>\n </section>\n </div>","PeriodicalId":154,"journal":{"name":"CNS Neuroscience & Therapeutics","volume":"31 6","pages":""},"PeriodicalIF":5.0000,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cns.70420","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"CNS Neuroscience & Therapeutics","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/cns.70420","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NEUROSCIENCES","Score":null,"Total":0}

引用次数: 0

Abstract

Aims

This study investigated the relationship between estimated glucose disposal rate (eGDR), a validated marker of insulin resistance, and stroke subtypes and poststroke outcomes. Despite eGDR's established role in predicting cardiovascular outcomes, its impact on stroke risk and prognosis has not been fully explored.

Methods

This study included 462,550 participants from the UK Biobank with eGDR assessments, and participants were stratified into three categories based on tertiles of eGDR. The primary outcomes were stroke and its subtypes (ischemic and hemorrhagic stroke). Cox proportional hazard models and restricted cubic spline regression were used to analyze associations between eGDR and outcomes. Secondary analyses investigated poststroke adverse events (depression, disability, epilepsy, and delirium). Mediation analyses were conducted to explore the underlying mechanisms driven by inflammatory markers, eGDR, and stroke.

Results

During a median follow-up of 13.9 years, 12,325 stroke cases were recorded. Compared to the lowest eGDR tertile (< 6.525 mg/kg/min), individuals in the highest tertile (> 8.494 mg/kg/min) demonstrated a significantly reduced risk of stroke (HR = 0.53, 95% CI: 0.50–0.56), particularly ischemic stroke (HR = 0.53, 95% CI: 0.50–0.57). Higher eGDR levels were also associated with a decreased risk of poststroke adverse outcomes (HR = 0.83, 95% CI: 0.73–0.94), with similar risk estimates observed for depression, disability, epilepsy, and delirium. Furthermore, inflammatory markers partially mediated the relationship between eGDR and stroke risk.

Conclusions

Elevated eGDR levels were associated with decreased risks of stroke and poststroke adverse outcomes. These findings suggest improving insulin sensitivity, as reflected by higher eGDR, maybe a potential therapeutic target for stroke prevention or stroke rehabilitation.

Abstract Image

查看原文本刊更多论文

估计葡萄糖处置率与卒中风险和卒中后不良后果的关联：一项前瞻性队列研究

目的本研究探讨了胰岛素抵抗的有效标志物葡萄糖处置率（eGDR）与脑卒中亚型和脑卒中后结局之间的关系。尽管eGDR在预测心血管预后方面的作用已经确立，但其对卒中风险和预后的影响尚未得到充分探讨。方法本研究纳入来自英国生物银行（UK Biobank）进行eGDR评估的462550名参与者，并根据eGDR的分位数将参与者分为三类。主要结局是卒中及其亚型（缺血性卒中和出血性卒中）。采用Cox比例风险模型和限制性三次样条回归分析eGDR与预后之间的关系。二次分析调查了中风后的不良事件（抑郁、残疾、癫痫和谵妄）。进行中介分析以探索炎症标志物、eGDR和卒中驱动的潜在机制。结果在中位13.9年的随访期间，记录了12,325例脑卒中病例。与eGDR最低组（6.525 mg/kg/min）相比，eGDR最高组（8.494 mg/kg/min）中风风险显著降低（HR = 0.53, 95% CI: 0.50-0.56），尤其是缺血性中风（HR = 0.53, 95% CI: 0.50-0.57）。较高的eGDR水平也与卒中后不良结局风险降低相关（HR = 0.83, 95% CI: 0.73-0.94），与抑郁、残疾、癫痫和谵妄的风险估计相似。此外，炎症标志物部分介导了eGDR与卒中风险之间的关系。结论：eGDR水平升高与卒中及卒中后不良结局风险降低相关。这些发现表明，提高胰岛素敏感性，如高eGDR所反映的，可能是中风预防或中风康复的潜在治疗靶点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

CNS Neuroscience & Therapeutics 医学-神经科学

CiteScore

7.30

自引率

12.70%

发文量

240

审稿时长

2 months

期刊介绍： CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.