Data Sheet 1_Association between estimated glucose disposal rate and incident cardiovascular disease in a population with Cardiovascular-Kidney-Metabolic syndrome stages 0–3: insights from CHARLS.zip

ObjectiveEstimated glucose disposal rate (eGDR) is a reliable marker of insulin resistance (IR), which has been proven to be strongly linked to cardiovascular and renal diseases. However, the link between eGDR and the occurrence of cardiovascular disease (CVD) in individuals exhibiting Cardiovascular-Kidney-Metabolic (CKM) syndrome stages 0–3 remains ambiguous.
MethodsThe data employed in this investigation was procured from the China Health and Retirement Longitudinal Study (CHARLS). The outcome of this study was CVD events, which include heart disease and stroke. Cox regression models and restricted cubic spline (RCS) were employed to investigate the association between eGDR and CVD risk among individuals with CKM syndrome stages 0–3.
ResultsThis investigation encompassed 6,539 subjects, and 54.43% were female. 1,656 (26.04%) CVD events were recorded. After fully adjusting for covariates, each 1-unit increase in eGDR was linked to a 9% diminish in CVD risk (HR: 0.91, 95% CI: 0.88, 0.93). In comparison to the bottom quartile of eGDR, the adjusted HRs (95% CIs) for the second to fourth quartiles were 0.73 (95% CI: 0.64, 0.83), 0.65 (95% CI: 0.56, 0.76), and 0.56 (95% CI: 0.47, 0.66), respectively. The RCS curves revealed a substantial negative nonlinear association between eGDR and CVD events among participants with CKM syndrome stages 0–3 (P-value < 0.001 and P for nonlinear = 0.009).
ConclusionsIn a population with CKM stages 0–3, a significant negative nonlinear relationship was observed between eGDR and CVD risk, suggesting that eGDR might function as a useful metric for evaluating CVD risk.

研究目的：估算葡萄糖处置率（estimated glucose disposal rate, eGDR）是胰岛素抵抗（insulin resistance, IR）的可靠标志物，现有研究已证实其与心血管及肾脏疾病存在密切关联。然而，在心血管-肾脏-代谢（Cardiovascular-Kidney-Metabolic, CKM）综合征0~3期人群中，eGDR与心血管疾病（cardiovascular disease, CVD）发生风险之间的关联仍不明确。
研究方法：本研究使用的数据来源于中国健康与养老追踪调查（China Health and Retirement Longitudinal Study, CHARLS）。本研究的结局指标为心血管疾病事件，涵盖心脏病与脑卒中。研究采用Cox回归模型与限制性立方样条（restricted cubic spline, RCS）分析，探讨CKM综合征0~3期人群中eGDR与CVD发病风险的关联。
研究结果：本研究共纳入6539名研究对象，其中女性占比54.43%；共计记录到1656例（26.04%）CVD事件。在充分校正混杂因素后，eGDR每升高1个单位，CVD发病风险降低9%（风险比HR=0.91，95%置信区间CI：0.88~0.93）。以eGDR最低四分位数组为参照，第2至第4四分位数组的校正后HR（95%CI）分别为0.73（95%CI：0.64~0.83）、0.65（95%CI：0.56~0.76）以及0.56（95%CI：0.47~0.66）。限制性立方样条曲线分析显示，在CKM综合征0~3期人群中，eGDR与CVD事件间存在显著的负向非线性关联（整体P<0.001，非线性检验P=0.009）。
结论：在CKM综合征0~3期人群中，eGDR与CVD发病风险存在显著负向非线性关联，提示eGDR可作为评估CVD发病风险的有效指标。