Joint association of estimated glucose disposal rate and a body shape index with stroke incidence

Both estimated glucose disposal rate (eGDR) and a body shape index (ABSI) are closely associated with the incidence of stroke. However, they are rarely used in combination. The aim of this study is to investigate the potential association between the combined use of eGDR and ABSI and the development of stroke. This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), including a total of 8,719 participants. After a follow-up period of up to nine years, data were collected on participants' sociodemographic information, marital status, health-related behaviors, the presence of underlying conditions, basic anthropometric measurements, and laboratory test results. Cox regression analysis was performed to examine the association between different subgroups and stroke incidence, and receiver operating characteristic (ROC) curves were used to evaluate predictive value. Meanwhile, we conducted subgroup analyses to explore the predictive performance across different populations. Among these participants, a total of 642 experienced a stroke during the follow-up period. Adjusted Cox regression models indicated that eGDR and ABSI were predictors of stroke. The hazard ratio (HR) for eGDR was 0.577 (95% CI: 0.454-0.734), and the HR for ABSI was 1.424 (95% CI: 1.120-1.812). Restricted cubic spline regression revealed the associations of ABSI and eGDR with stroke. There was no statistically significant difference in diagnostic performance for stroke incidence between eGDR alone and the combination of ABSI and eGDR (P = 0.080); however, a statistically significant difference was observed between ABSI alone and the combination (P < 0.001). Subgroup analyses further validated the robustness of the association between the combination of eGDR and ABSI and the development of stroke. The combined prediction of eGDR and ABSI has a certain clinical value, as it can help identify individuals at risk of stroke in the general population, thereby enabling monitoring and intervention based on this combined index to reduce the burden of stroke.