| Title: | Estimated glucose disposal rate for predicting cardiovascular events and mortality in patients with non-diabetic chronic kidney disease: a prospective cohort study |
| Journal: | BMC Medicine |
| Published: | 27 Sep 2024 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/39334214/ |
| DOI: | https://doi.org/10.1186/s12916-024-03582-x |
Publication 13365
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Abstract
BackgroundEvidence suggests that insulin resistance (IR) is an autonomous risk factor for cardiovascular disease (CVD). Nevertheless, the association between estimated glucose disposal rate (eGDR), a novel indicator of IR, and incident CVD and mortality in chronic kidney disease (CKD) patients without diabetes remains uncertain.MethodsThe study included 19,906 participants from the UK Biobank who had an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2 or a urinary albumin-to-creatinine ratio (UACR) ≥ 30 mg/g and no history of CVD and diabetes. Individuals were divided into three categories based on tertiles of eGDR. The outcome was a composite CVD (coronary heart disease (CHD) and stroke) and mortality (all-cause, non-accidental, and cardiovascular mortality). Furthermore, a cohort of 1,600 individuals from the US National Health and Nutrition Examination Survey (NHANES) was applied to validate the association between eGDR and mortality. The Cox proportional hazards regression models were used to examine the association between eGDR and event outcomes.ResultsDuring a follow-up of around 12 years, 2,860 CVD, 2,249 CHD, 783 stroke, 2,431 all-cause, 2,326 non-accidental and 492 cardiovascular deaths were recorded from UK Biobank. Higher eGDR level was not only associated with lower risk of CVD (hazard ratio [HR] 0.641, 95% confidence interval [CI] 0.559-0.734), CHD (HR 0.607, 95% CI 0.520-0.709), stroke (HR 0.748, 95% CI 0.579-0.966), but also related to reduced risk of all-cause (HR 0.803, 95% CI 0.698-0.923), non-accidental (HR 0.787, 95% CI 0.682-0.908), and cardiovascular mortality (HR 0.592, 95% CI 0.423-0.829). Validation analyses from NHANES yielded consistent relationship on mortality.ConclusionsIn these two large cohorts of CKD patients without DM, a higher eGDR level was associated with a decreased risk of CVD and mortality.</p>
15 Keywords
- Adult
- Aged
- Blood Glucose
- Cardiovascular Diseases
- Female
- Glomerular Filtration Rate
- Glucose
- Humans
- Insulin Resistance
- Male
- Middle Aged
- Prospective Studies
- Renal Insufficiency, Chronic
- Risk Factors
- United Kingdom
8 Authors
- Juan Peng
- Yan Zhang
- Yiqun Zhu
- Weilin Chen
- Li Chen
- Fangyu Ma
- Bin Yi
- Zhijun Huang
1 Application
| Application ID | Title |
|---|---|
| 90060 | Associations of Lifestyle, Environmental factor, Genetic Risk with Aging-related Diseases |
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