Kim Myung Jin, Cho Yun Kyung, Kim Eun Hee, Lee Min Jung, Lee Woo Je, Kim Hong-Kyu, Jung Chang Hee
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea; Asan Diabetes Center, Asan Medical Center, Seoul, 05505, Republic of Korea.
Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea.
Nutr Metab Cardiovasc Dis. 2025 Jan;35(1):103686. doi: 10.1016/j.numecd.2024.07.004. Epub 2024 Jul 14.
The estimated glucose disposal rate (eGDR) is an easily accessible clinical parameter for assessing insulin resistance in patients with diabetes mellitus. In this study, we aimed to investigate the link between eGDR and subclinical coronary atherosclerosis in an asymptomatic middle-aged Korean population.
This study involved 4004 subjects who underwent routine health checkups with coronary multidetector computed tomography (MDCT) at Asan Medical Center from 2007 to 2011, among whom 913 had a follow-up analysis through 2014. The eGDR was calculated using: 21.16 - (0.09 ∗ waist circumference [cm]) - (3.41 ∗ hypertension) - (0.55 ∗ glycated hemoglobin [%]). Patients were categorized into three groups according to the tertiles of eGDR. Subclinical coronary atherosclerosis was defined by significant coronary stenosis (≥50%), presence of plaques, coronary artery calcification (CAC) score, and its progression. As a result, a lower eGDR level was associated with higher prevalence of significant coronary stenosis, plaques, moderate to severe CAC, and CAC progression. Compared to other markers or risk scores, eGDR was superior to other biomarkers of insulin resistance but did not provide additional information beyond classic cardiovascular risk models like the Framingham Risk Score and Pooled Cohort Equations.
Decreased eGDR values were significantly associated with higher subclinical coronary atherosclerosis burdens in an asymptomatic middle-aged Korean population. However, its clinical implications remain uncertain due to its weaker performance compared to established cardiovascular risk models.
估计葡萄糖处置率（eGDR）是评估糖尿病患者胰岛素抵抗的一个易于获取的临床参数。在本研究中，我们旨在调查无症状中年韩国人群中eGDR与亚临床冠状动脉粥样硬化之间的联系。
本研究纳入了2007年至2011年在峨山医学中心接受冠状动脉多层螺旋计算机断层扫描（MDCT）常规健康检查的4004名受试者，其中913名受试者随访至2014年。eGDR的计算方法为：21.16 - （0.09×腰围[厘米]） - （3.41×高血压） - （0.55×糖化血红蛋白[百分比]）。根据eGDR的三分位数将患者分为三组。亚临床冠状动脉粥样硬化的定义为显著冠状动脉狭窄（≥50%）、斑块存在、冠状动脉钙化（CAC）评分及其进展。结果显示，较低的eGDR水平与显著冠状动脉狭窄、斑块、中度至重度CAC以及CAC进展的较高患病率相关。与其他标志物或风险评分相比，eGDR优于其他胰岛素抵抗生物标志物，但在弗雷明汉风险评分和汇总队列方程等经典心血管风险模型之外并未提供额外信息。
在无症状中年韩国人群中，eGDR值降低与较高的亚临床冠状动脉粥样硬化负担显著相关。然而，由于与既定的心血管风险模型相比其表现较弱，其临床意义仍不确定。
