Estimated glucose disposal rate and cardiovascular risk in metabolically healthy adults: a nationwide prospective cohort study

To investigate the association of estimated glucose disposal rate (eGDR) with CVD, including stroke and heart disease, in metabolically healthy adults. All data were drawn from the China Health and Retirement Longitudinal Study, including participants aged ≥ 45 years who were free of metabolic syndrome (MetS) at baseline. Participants were enrolled in 2015 and followed up in 2018 and 2020. The association between eGDR and CVD was evaluated using multivariable Cox regression models and restricted cubic spline (RCS). Among the 4999 participants, the median age was 61 (IQR: 55-68) years, and 2838 (56.77%) were female. During the 5-year follow-up, 885 (17.70%) individuals experienced incident CVD events, comprising 322 (6.44%) cases of stroke and 653 (13.06%) of heart disease. After adjustment for other covariates, higher eGDR levels were independently associated with lower risks of CVD (HR = 0.47, 95% CI 0.37-0.61), stroke (HR = 0.39, 95% CI 0.25-0.61), and heart disease (HR = 0.51, 95% CI 0.38-0.68). RCS analysis indicated a significant linear association of eGDR with CVD and its subtypes (all P for nonlinearity > 0.05). Higher levels of eGDR were significantly associated with a decreased risk of CVD and its subtypes in metabolically healthy individuals.