Relationship Between a Novel Model of Insulin Sensitivity and Arterial Stiffness in Non-Obese Patients with Type 2...

Insulin resistance (IR) is closely associated with arterial stiffness (AS) and cardiovascular diseases (CVDs). Recently, several non-insulin-based IR surrogate markers have been demonstrated to be related to AS. The natural log transformation of the glucose disposal rate (log_e GDR) is a novel indicator of insulin sensitivity (IS) developed in patients with type 2 diabetes (T2D). We aim to investigate the relationship between the log_e GDR and AS in non-obese patients with T2D.

A cross-sectional study of 790 non-obese patients with T2D were included. Clinical and biochemical characteristics were collected. AS was assessed by brachial-ankle pulse wave velocity (baPWV), and according to the baPWV levels, patients were divided into two groups: AS group (baPWV ≥ 1800 cm/s) and non-AS group (baPWV < 1800 cm/s). The correlation between AS and log_e GDR was analyzed.

Compared with the non-AS group, the log_e GDR decreased in the AS group (P < 0.001). With the tertiles of log_e GDR increased, the bapWV and the prevalence of AS were decreased (both P < 0.001). Univariate analysis showed that the log_e GDR was negatively correlated with the baPWV and AS (both P < 0.001). Furthermore, multivariate regression analyses demonstrated that the log_e GDR was independently associated with bapWV (β: -0.162; P < 0.001) and AS (OR: 0.286; 95% CI: 0.110-0.743). Integrating log_e GDR modestly improved the ability of the model to identify AS (Net reclassification improvement (NRI): 0.043, 95% CI 0.009-0.079, P = 0.011).

The log_e GDR is independently correlated with AS in non-obese patients with T2D, and its utility for risk stratification requires further validation.