Association between estimated glucose disposal rate and cardiovascular disease risk across different Sarcopenia statuses: A retrospective cohort study

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-06-06 DOI:10.1016/j.clnesp.2025.06.001

Xiongmu Tan , Xiaoqin Chen , Yanrui shen, Yinqiu Wang, Linyan Huang, Liqing Peng

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Abstract

Background

Recent research indicates that the estimated glucose disposal rate (eGDR) is regarded as a reliable surrogate marker for insulin resistance (IR) and is associated with the incidence of cardiovascular diseases (CVD). Sarcopenia, characterized by a decline in skeletal muscle mass, strength, or physical function, exhibits complex interactions with chronic diseases. This study aims to investigate the association between eGDR, sarcopenia, and CVD among middle-aged and elderly individuals, and to explore the potential impact of eGDR on CVD risk in the overall population as well as stratified by sarcopenia status.

Materials and methods

This study comprised 5938 participants who were free of cardiovascular disease at baseline and possessed complete data on sarcopenia-related indicators and eGDR. The primary endpoint was the occurrence of cardiovascular events. The relationship between baseline eGDR levels and the incidence of CVD among individuals with sarcopenia was analyzed using Kaplan–Meier curves, multivariable Cox proportional hazards models, restricted cubic spline analysis, subgroup analysis, and sensitivity analysis.

Results

During an average follow-up of 8.14 years, cardiovascular events occurred in 1164 participants (19.6 %). The risk of cardiovascular events decreased with each quartile (Q) increase in baseline eGDR levels. Kaplan–Meier curve analysis revealed significant differences in cardiovascular incidence among all participants across eGDR groups (P < 0.05). After adjusting for potential confounding factors, the cardiovascular risk for participants in Q2, Q3, and Q4 was significantly lower than that in Q1. The hazard ratios (95 % confidence intervals) for CVD in groups Q2, Q3, and Q4 were 0.71 (0.61–0.82), 0.57 (0.47–0.68), and 0.55 (0.45–0.67), respectively. Furthermore, in all three Cox models, high levels of eGDR were associated with a reduced risk of cardiovascular events in non-sarcopenic, possibly sarcopenic, and sarcopenic individuals.

Conclusion

Elevated baseline eGDR levels are significantly associated with a reduced risk of CVD in middle-aged and elderly individuals, exhibiting notable characteristics in both non-sarcopenic and sarcopenic populations.

查看原文本刊更多论文

在不同肌肉减少症状态下，估计葡萄糖处理率与心血管疾病风险之间的关系：一项回顾性队列研究

背景：最近的研究表明，估计葡萄糖处置率（eGDR）被认为是胰岛素抵抗（IR）的可靠替代标志物，并与心血管疾病（CVD）的发病率相关。骨骼肌减少症以骨骼肌质量、力量或身体功能下降为特征，与慢性疾病表现出复杂的相互作用。本研究旨在探讨中老年人eGDR、肌肉减少症和心血管疾病之间的关系，并探讨eGDR对整体人群以及按肌肉减少症分层的心血管疾病风险的潜在影响。材料和方法：本研究纳入5938名受试者，他们在基线时无心血管疾病，并拥有肌少症相关指标和eGDR的完整数据。主要终点是心血管事件的发生。采用Kaplan-Meier曲线、多变量Cox比例风险模型、受限三次样条分析、亚组分析和敏感性分析，分析基线eGDR水平与肌少症患者心血管疾病发生率之间的关系。结果：在平均8.14年的随访期间，1164名参与者（19.6%）发生心血管事件。基线eGDR水平每增加四分位数(Q)，心血管事件的风险就会降低。Kaplan-Meier曲线分析显示，eGDR组所有参与者的心血管发病率差异有统计学意义（P < 0.05）。在调整了潜在的混杂因素后，第二季度、第三季度和第四季度参与者的心血管风险显著低于第一季度。Q2、Q3和Q4组CVD的风险比（95%可信区间）分别为0.71（0.61-0.82）、0.57（0.47-0.68）和0.55（0.45-0.67）。此外，在所有三种Cox模型中，高水平的eGDR与非肌少症、可能肌少症和肌少症患者心血管事件风险降低相关。结论：eGDR基线水平升高与中老年人心血管疾病风险降低显著相关，在非肌肉减少症和肌肉减少症人群中均表现出显著特征。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.