ArticleCardiovascular diabetology2026
Estimated glucose disposal rate outperforms inflammation surrogate markers in predicting cardiometabolic multimorbidity among middle-aged and older adults.
Article in Cardiovascular diabetology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundBoth estimated glucose disposal rate (eGDR) and inflammation surrogate (high-sensitivity C-reactive protein [hs-CRP]) have emerged as potential markers reflecting metabolic health. However, their comparative predictive value for cardiometabolic multimorbidity remains unclear, particularly in middled-aged and older populations where both metabolic dysfunction and low-grade inflammation are highly prevalent.
methodsThis prospective cohort study included 7,589 participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study (CHARLS) with complete baseline data. The primary outcome was incident cardiometabolic multimorbidity, defined as the co-occurrence of two or more cardiometabolic conditions, including diabetes, heart disease, and stroke. Cox proportional hazards models were employed to assess separate and joint associations. Concordance index (C-index) was used to evaluate the predictive capacity.
resultsOver a 9-year follow-up period, 2,263 participants developed cardiometabolic multimorbidity. In models adjusting for traditional risk factors, lower eGDR (lowest vs. highest quartile: hazard ratio [HR] 2.07, 95% CI 1.80-2.38) remained significantly associated with increased risk of cardiometabolic multimorbidity. In joint associations, participants with low eGDR exhibited consistently elevated cardiometabolic multimorbidity risk regardless of inflammation surrogate status (HR 1.52 (95% CI 1.33-1.74) in those with low inflammation and HR 1.80 (95% CI 1.58-2.04) in those with high inflammation). Addition of eGDR to the basic model (which included covariates) yielded a significantly higher C-index (0.676) compared to hs-CRP (0.643, P < 0.001).
conclusionsAmong middle-aged and older adults, eGDR is significantly associated with incident cardiometabolic multimorbidity regardless of inflammation status. Low eGDR demonstrates superior discriminative ability compared to hs-CRP. These findings suggest that eGDR may serve as a more comprehensive biomarker for cardiometabolic risk stratification by capturing insulin resistance and metabolic dysfunction.
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