Key result
Higher estimated glucose disposal rate is linked to ~51% lower incident CVD risk.
Why the study?
The association between estimated glucose disposal rate (eGDR), a simple non-invasive proxy for early-stage metabolic dysfunction, and the risk of CVD, MACE, and MACE plus heart failure among diabetes-free people needed to be explored.
Is a higher estimated glucose disposal rate (eGDR) associated with a lower risk of incident cardiovascular disease, MACE, and MACE+ in diabetes-free adults, and does lifestyle modify this association?
Cohort (n=401,094)
Yes
Is a higher estimated glucose disposal rate (eGDR) associated with a lower risk of incident cardiovascular disease, MACE, and MACE+ in diabetes-free adults, and does lifestyle modify this association?
In over 400,000 diabetes-free UK adults, a higher estimated glucose disposal rate (eGDR)—reflecting lower metabolic and hemodynamic burden—was strongly associated with reduced risks of incident CVD, MACE, and heart failure hospitalization across both normoglycemic and prediabetic strata, while a favorable lifestyle partially mitigated the excess risk associated with low eGDR.
Answers are grounded in this paper and cite their sources.
eGDR may aid CVD risk stratification in diabetes-free adults; leaves open whether targeting insulin sensitivity prevents events.
Background We aimed to explore the association between estimated glucose disposal rate (eGDR) – a simple, non-invasive proxy for early-stage metabolic dysfunction and the risk of cardiovascular disease (CVD), major adverse cardiovascular events (MACE) and MACE plus heart failure (MACE+) among diabetes-free people. Methods We included 401,094 adults from the UK Biobank without baseline diabetes or CVD. eGDR was calculated and split into quartiles. Favorable lifestyle was defined as never smoking, no heavy drinking, and regular physical activity. CVD (atrial fibrillation, coronary heart disease, heart failure, and stroke), MACE (CV death, non-fatal acute coronary syndrome, and ischemic stroke), and MACE+ (MACE plus hospitalization for heart failure) were ascertained based on medical records and death records. Data were analyzed using Cox regression. Results Over a median follow-up of 12.83 (range from 0.003 to 16.031) years, 54,835 (13.67%) participants developed CVD, 16,704 (4.17%) developed MACE, and 23,593 (5.88%) developed MACE+. Compared to low eGDR, the hazard ratio (HR) and 95% confidence interval (CI) of high eGDR was 0.49 (0.47, 0.51) for CVD, 0.48 (0.45, 0.52) for MACE, and 0.43 (0.41, 0.46) for MACE+. Low eGDR plus unfavorable lifestyle was associated with a 110% (HR: 2.10 [1.97, 2.23]) higher risk of CVD, 158% (HR: 2.58 [2.28, 2.93]) higher risk of MACE, and 176% (HR: 2.76 [2.48, 3.08]) higher risk of MACE+ relative to high eGDR and favorable lifestyle. An additive interaction was observed between low eGDR and unfavorable lifestyle for CVD, MACE, and MACE+. Conclusions In this study, higher eGDR was associated with a lower risk of CV events among individuals with prediabetes and normoglycemia. Lifestyle could modify the association of eGDR on CV events.
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Wang et al. (2026) conducted a cohort in Diabetes-free adults without baseline cardiovascular disease (n=401,094). High estimated glucose disposal rate (eGDR Quartile 4: >10.61 mg/kg/min) vs. Low estimated glucose disposal rate (eGDR Quartile 1: <=6.51 mg/kg/min) was evaluated on Incident cardiovascular disease (composite of atrial fibrillation, coronary heart disease, heart failure, and stroke) (HR 0.49, 95% CI 0.47, 0.51). Higher estimated glucose disposal rate (Q4 vs Q1) was associated with a 51% lower risk of incident cardiovascular disease in diabetes-free adults.
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