Linking Estimated Glucose Disposal Rate to Major Adverse Cardio-Cerebrovascular Events in Populations With and Without Diabetes: A Systematic Review and Meta-Analysis.

BACKGROUND

Insulin resistance (IR) contributes significantly to major adverse cardio-cerebrovascular events (MACCE), with the estimated glucose disposal rate (eGDR) serving as a novel marker for assessing IR. This systematic review and meta-analysis investigate the association between eGDR and MACCE outcomes, aiming to clarify its predictive value across different diabetes statuses.

METHODS

We searched databases for studies examining the relationship between eGDR and MACCE, including myocardial infarction (MI), stroke, ischemic heart disease (IHD), cardiovascular disease (CVD), and all-cause mortality. We compared groups with the lowest versus highest eGDR. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using random effect models. Subgroup analyses assessed eGDR efficacy by diabetes status.

RESULTS

Our search identified 16 studies with 198 626 participants. The group with the lowest eGDR had a significantly higher risk of MACCE compared to the group with the highest eGDR (HR = 2.21, 95% CI 1.17-4.18). Additionally, the group with the lowest eGDR had notably worse outcomes for all-cause mortality, MI, stroke, CVD, and IHD with HRs of 2.03 (95% CI 1.05-3.90), 1.82 (95% CI 1.30-2.55), 2.82 (95% CI 1.66-4.69), 2.95 (95% CI 1.99-4.37), and 7.97 (95% CI 2.57-24.73), respectively. Subgroup analyses revealed consistent results for CVD in both populations with diabetes and non-diabetes status, for stroke in the population with non-diabetes status, and for IHD in the population with diabetes.

CONCLUSIONS

Lower eGDR, indicating higher IR, is linked with a significantly increased risk of MACCE. This parameter could enhance risk stratification models for predicting MACCE. Further studies are needed to evaluate the clinical role of eGDR in managing cardio-cerebrovascular risk across subgroups.