Associations between estimated glucose disposal rate and peripheral artery disease: evidence from the UK Biobank and
Jilang Zeng1, Xinjie Zeng1, Weihong Lin1
1Department of Cardiology, Fujian Medical University Union Hospital, Fujian Cardiovascular Medicine Center, Fujian Institute of Coronary Artery Disease, Fujian Cardiovascular Research Center, Fujian Medical University Heart Center, NO.29, Xinquan Road, Fuzhou, 350001, Fujian Province, China.
Background:
Insulin resistance (IR) is considered a key pathogenic mechanism of peripheral artery disease (PAD). The estimated glucose disposal rate (eGDR) serves as a practical surrogate marker of IR. The study aimed to investigate the association between eGDR and incident PAD risk in the general population.
Methods:
A total of 456,743 participants free of PAD at baseline were included from the prospective UK Biobank cohort. In addition, we examined the cross-sectional association between eGDR and prevalent PAD among 7,208 participants from the National Health and Nutrition Examination Survey (NHANES) as a supplementary analysis.
Results:
Multivariable Cox regression analysis showed that participants in the highest eGDR quartile (Q4) experienced the greatest reduction in the risk of developing PAD compared with the reference group [Q4 vs. Q1; fully adjusted hazard ratio (HR) = 0.67, 95% confidence interval (CI): 0.63-0.72, P < 0.001]. Restricted cubic spline (RCS) curve and threshold effect analysis also suggested a significant nonlinear inverse relationship between eGDR and PAD risk, with an inflection point at 7.829 (P for overall < 0.001; P for nonlinearity < 0.001). Two-piecewise Cox regression further indicated that below the threshold, an increase in eGDR was associated with a greater reduction in PAD risk (HR = 0.85, 95% CI: 0.84-0.87, P < 0.001). A similar inverse association between eGDR and prevalent PAD was observed in the NHANES analysis.
Conclusions:
eGDR was inversely associated with PAD. Further studies are needed to explore the clinical utility of this association.
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