Association between estimated glucose disposal rate and cardiovascular disease risk across different Sarcopenia statuses: A retrospective cohort study.

BACKGROUND

Recent research indicates that the estimated glucose disposal rate (eGDR) is regarded as a reliable surrogate marker for insulin resistance (IR) and is associated with the incidence of cardiovascular diseases (CVD). Sarcopenia, characterized by a decline in skeletal muscle mass, strength, or physical function, exhibits complex interactions with chronic diseases. This study aims to investigate the association between eGDR, sarcopenia, and CVD among middle-aged and elderly individuals, and to explore the potential impact of eGDR on CVD risk in the overall population as well as stratified by sarcopenia status.

MATERIALS AND METHODS

This study comprised 5938 participants who were free of cardiovascular disease at baseline and possessed complete data on sarcopenia-related indicators and eGDR. The primary endpoint was the occurrence of cardiovascular events. The relationship between baseline eGDR levels and the incidence of CVD among individuals with sarcopenia was analyzed using Kaplan-Meier curves, multivariable Cox proportional hazards models, restricted cubic spline analysis, subgroup analysis, and sensitivity analysis.

RESULTS

During an average follow-up of 8.14 years, cardiovascular events occurred in 1164 participants (19.6 %). The risk of cardiovascular events decreased with each quartile (Q) increase in baseline eGDR levels. Kaplan-Meier curve analysis revealed significant differences in cardiovascular incidence among all participants across eGDR groups (P < 0.05). After adjusting for potential confounding factors, the cardiovascular risk for participants in Q2, Q3, and Q4 was significantly lower than that in Q1. The hazard ratios (95 % confidence intervals) for CVD in groups Q2, Q3, and Q4 were 0.71 (0.61-0.82), 0.57 (0.47-0.68), and 0.55 (0.45-0.67), respectively. Furthermore, in all three Cox models, high levels of eGDR were associated with a reduced risk of cardiovascular events in non-sarcopenic, possibly sarcopenic, and sarcopenic individuals.

CONCLUSION

Elevated baseline eGDR levels are significantly associated with a reduced risk of CVD in middle-aged and elderly individuals, exhibiting notable characteristics in both non-sarcopenic and sarcopenic populations.