{"title":"估计葡萄糖处置率和高敏c反应蛋白对中国中老年成人心血管疾病发生风险的影响：一项全国前瞻性队列研究","authors":"Linghao Xu, Jiangping Ma, Yong Xu","doi":"10.1186/s12944-025-02653-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>Cardiovascular diseases (CVD) remain the predominant contributor to global mortality and morbidity, necessitating enhanced strategies for primary prevention and early detection. This investigation sought to characterize the associations between estimated glucose disposal rate (eGDR), high sensitivity C-reactive protein (hsCRP), and incident CVD.</p><p><strong>Methods: </strong>The research used data from China Health and Retirement Longitudinal Study (CHARLS). The primary exposures included eGDR and hsCRP. Incident CVD served as the primary study endpoint. All statistical analyses were performed utilizing SPSS software (version 25.0) and R software (version 4.4.4).</p><p><strong>Results: </strong>The analysis of 7,742 participants revealed incident CVD in 1,981 cases (25.6%), with Kaplan-Meier curves demonstrating significantly elevated cumulative incidence among individuals exhibiting both reduced eGDR and elevated hsCRP levels. Significant interactions were observed between these biomarkers, including an additive effect (relative excess risk due to interaction = 0.09, 95% confidence interval [CI]: 0.03-0.14) and a multiplicative effect (hazard ratio = 1.02, 95% CI: 1.01-1.03). Mediation analyses indicated bidirectional relationships, with eGDR accounting for 5.81% (95% CI: 2.13-9.49%) of the hsCRP-CVD association and hsCRP mediating 8.52% (95% CI: 3.87-13.17%) of the eGDR-CVD relationship. Notably, in individuals with diabetes, the combined predictive capacity of eGDR and hsCRP (area under the curve: 0.645) demonstrated superior discriminative performance compared to either biomarker alone (AUC: 0.645).</p><p><strong>Conclusion: </strong>eGDR and hsCRP exert significant joint, interactive and mediating effects on incident CVD in middle-aged and elderly Chinese population. Using eGDR (10.52 mg/kg/min) and hsCRP (1 mg/L) thresholds can be an affordable screening tool in primary care, especially where advanced diagnostics are lacking. Incorporating these assessments into regular check-ups may lower long-term CVD complications and reduce economic burdens.</p>","PeriodicalId":18073,"journal":{"name":"Lipids in Health and Disease","volume":"24 1","pages":"234"},"PeriodicalIF":3.9000,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239268/pdf/","citationCount":"0","resultStr":"{\"title\":\"The effects of estimated glucose disposal rate and high sensitivity C-reactive protein on risk of incident cardiovascular diseases in middle-aged and elderly Chinese adults: a nationwide prospective cohort study.\",\"authors\":\"Linghao Xu, Jiangping Ma, Yong Xu\",\"doi\":\"10.1186/s12944-025-02653-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>Cardiovascular diseases (CVD) remain the predominant contributor to global mortality and morbidity, necessitating enhanced strategies for primary prevention and early detection. This investigation sought to characterize the associations between estimated glucose disposal rate (eGDR), high sensitivity C-reactive protein (hsCRP), and incident CVD.</p><p><strong>Methods: </strong>The research used data from China Health and Retirement Longitudinal Study (CHARLS). The primary exposures included eGDR and hsCRP. Incident CVD served as the primary study endpoint. All statistical analyses were performed utilizing SPSS software (version 25.0) and R software (version 4.4.4).</p><p><strong>Results: </strong>The analysis of 7,742 participants revealed incident CVD in 1,981 cases (25.6%), with Kaplan-Meier curves demonstrating significantly elevated cumulative incidence among individuals exhibiting both reduced eGDR and elevated hsCRP levels. Significant interactions were observed between these biomarkers, including an additive effect (relative excess risk due to interaction = 0.09, 95% confidence interval [CI]: 0.03-0.14) and a multiplicative effect (hazard ratio = 1.02, 95% CI: 1.01-1.03). Mediation analyses indicated bidirectional relationships, with eGDR accounting for 5.81% (95% CI: 2.13-9.49%) of the hsCRP-CVD association and hsCRP mediating 8.52% (95% CI: 3.87-13.17%) of the eGDR-CVD relationship. Notably, in individuals with diabetes, the combined predictive capacity of eGDR and hsCRP (area under the curve: 0.645) demonstrated superior discriminative performance compared to either biomarker alone (AUC: 0.645).</p><p><strong>Conclusion: </strong>eGDR and hsCRP exert significant joint, interactive and mediating effects on incident CVD in middle-aged and elderly Chinese population. Using eGDR (10.52 mg/kg/min) and hsCRP (1 mg/L) thresholds can be an affordable screening tool in primary care, especially where advanced diagnostics are lacking. Incorporating these assessments into regular check-ups may lower long-term CVD complications and reduce economic burdens.</p>\",\"PeriodicalId\":18073,\"journal\":{\"name\":\"Lipids in Health and Disease\",\"volume\":\"24 1\",\"pages\":\"234\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2025-07-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239268/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Lipids in Health and Disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12944-025-02653-z\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"BIOCHEMISTRY & MOLECULAR BIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lipids in Health and Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12944-025-02653-z","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"BIOCHEMISTRY & MOLECULAR BIOLOGY","Score":null,"Total":0}
The effects of estimated glucose disposal rate and high sensitivity C-reactive protein on risk of incident cardiovascular diseases in middle-aged and elderly Chinese adults: a nationwide prospective cohort study.
Aim: Cardiovascular diseases (CVD) remain the predominant contributor to global mortality and morbidity, necessitating enhanced strategies for primary prevention and early detection. This investigation sought to characterize the associations between estimated glucose disposal rate (eGDR), high sensitivity C-reactive protein (hsCRP), and incident CVD.
Methods: The research used data from China Health and Retirement Longitudinal Study (CHARLS). The primary exposures included eGDR and hsCRP. Incident CVD served as the primary study endpoint. All statistical analyses were performed utilizing SPSS software (version 25.0) and R software (version 4.4.4).
Results: The analysis of 7,742 participants revealed incident CVD in 1,981 cases (25.6%), with Kaplan-Meier curves demonstrating significantly elevated cumulative incidence among individuals exhibiting both reduced eGDR and elevated hsCRP levels. Significant interactions were observed between these biomarkers, including an additive effect (relative excess risk due to interaction = 0.09, 95% confidence interval [CI]: 0.03-0.14) and a multiplicative effect (hazard ratio = 1.02, 95% CI: 1.01-1.03). Mediation analyses indicated bidirectional relationships, with eGDR accounting for 5.81% (95% CI: 2.13-9.49%) of the hsCRP-CVD association and hsCRP mediating 8.52% (95% CI: 3.87-13.17%) of the eGDR-CVD relationship. Notably, in individuals with diabetes, the combined predictive capacity of eGDR and hsCRP (area under the curve: 0.645) demonstrated superior discriminative performance compared to either biomarker alone (AUC: 0.645).
Conclusion: eGDR and hsCRP exert significant joint, interactive and mediating effects on incident CVD in middle-aged and elderly Chinese population. Using eGDR (10.52 mg/kg/min) and hsCRP (1 mg/L) thresholds can be an affordable screening tool in primary care, especially where advanced diagnostics are lacking. Incorporating these assessments into regular check-ups may lower long-term CVD complications and reduce economic burdens.
期刊介绍：
Lipids in Health and Disease is an open access, peer-reviewed, journal that publishes articles on all aspects of lipids: their biochemistry, pharmacology, toxicology, role in health and disease, and the synthesis of new lipid compounds.
Lipids in Health and Disease is aimed at all scientists, health professionals and physicians interested in the area of lipids. Lipids are defined here in their broadest sense, to include: cholesterol, essential fatty acids, saturated fatty acids, phospholipids, inositol lipids, second messenger lipids, enzymes and synthetic machinery that is involved in the metabolism of various lipids in the cells and tissues, and also various aspects of lipid transport, etc. In addition, the journal also publishes research that investigates and defines the role of lipids in various physiological processes, pathology and disease. In particular, the journal aims to bridge the gap between the bench and the clinic by publishing articles that are particularly relevant to human diseases and the role of lipids in the management of various diseases.
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