Key result
Higher eGDR and adequate physical activity are linked to ~7% lower incident CVD risk.
Why the study?
Insulin resistance and physical activity are key cardiometabolic factors, but their combined impact on cardiovascular disease incidence remains unclear.
Does higher estimated glucose disposal rate and adequate physical activity reduce the incidence of cardiovascular disease in adults aged 45 and older?
Cohort (n=3,984)
Yes
Does higher estimated glucose disposal rate and adequate physical activity reduce the incidence of cardiovascular disease in adults aged 45 and older?
Hazard Ratio: 0.93 (95% CI 0.886–0.977)
Higher insulin sensitivity and adequate physical activity synergistically reduce the risk of incident cardiovascular disease, particularly in individuals without diabetes or chronic kidney disease.
May support eGDR and activity assessment for CVD risk stratification in adults ≥45; hypothesis-generating for synergistic prevention in trials.
Cardiovascular disease (CVD) leads global mortality. Insulin resistance (IR) and physical activity (PA) are key cardiometabolic factors, yet their combined impact remains unclear. This study explores the independent and combined links of IR and PA to CVD incidence across diverse populations. This prospective analysis involved the China Health and Retirement Longitudinal Study (CHARLS). The estimated glucose disposal rate (eGDR) was calculated via waist circumference, hypertension status, and Glycated Hemoglobin A1c (HbA1c). PA was divided into ≥ 600 MET-minutes/week and < 600 MET-minutes/week. The main outcomes were new CVD cases (self-reported). Lower eGDR and insufficient PA were independently tied to higher CVD incidence (eGDR: HR = 0.930, 95%CI = [0.886, 0.977]; PA: HR = 0.818, 95%CI = [0.699, 0.958]). A synergistic eGDR-PA interaction in cutting CVD risks emerged. Benefits occurred with/without diabetes (DM) or chronic kidney disease (CKD), without DM: OR = 0.412, 95%CI = [0.186, 0.890]; with DM: OR = 0.342, 95%CI = [0.112, 1.000]; without CKD: OR = 0.669, 95%CI = [0.502, 0.905]. Population-attributable fractions indicated optimizing eGDR and PA might prevent 19.6% of CVD cases. Mediation analyses found eGDR mediated PA’s effect on CVD incidence, accounting for 25.723%. Low eGDR and insufficient PA together hike CVD risk, especially in people without CKD or DM. The findings underscore the need to enhance metabolic health and PA adherence early to cut CVD burden.
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Duan et al. (2026) conducted a cohort in Cardiovascular disease (n=3,984). Estimated glucose disposal rate (eGDR) and physical activity (PA) vs. Higher eGDR and adequate PA (≥600 MET-minutes/week) was evaluated on Incident cardiovascular disease (self-reported heart disease and stroke) (HR 0.930, 95% CI 0.886-0.977). Higher estimated glucose disposal rate and adequate physical activity independently reduced incident cardiovascular disease risk (eGDR HR 0.930; PA HR 0.818), with their combination demonstrating a synergistic protective effect.
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