Assessment of seven insulin resistance surrogate indexes for predicting cardiometabolic multimorbidity among Chinese middle-aged and older adults: a national prospective cohort study
Authors' conclusion
All seven insulin resistance surrogate indexes independently demonstrated elevated CMM risk. In the context of Chinese middle-aged and elderly cohorts, eGDR demonstrated a notable predictive capacity for CMM. ROC-derived cut-offs (eGDR < 7.64) are utilised for identifying high-risk individuals requiring intervention. Spline-derived thresholds (eGDR = 11.82) serve as therapeutic targets for risk reduction.
Study context
- Population
- Chinese participants aged ≥ 45 years, China Health and Retirement Longitudinal Study (CHARLS) 2011–2020
- Participants
- 7,197 participants
- Exposure
- Seven IR surrogate indexes for predicting cardiometabolic multimorbidity (CMM)
- Outcome
- Incident cardiometabolic multimorbidity (CMM)
- Follow-up
- Median 9 years
Methodological detailsnational, CHARLS 2011-2020
- National
- CHARLS 2011-2020
Main finding
As reported in the abstract
Developed CMM
1043
14.49%
Estimated glucose disposal rate (eGDR), per SD increase: adjusted HR
0.834 (0.781-0.891) (95% CI)
Observational data: associations, not effects.
Further findings
Nonlinearity (restricted cubic splines (RCS))
- TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), Metabolic score for IR (METS-IR) and eGDR nonlinearly associated with incident CMM
- P-nonlinearity < 0.05
- eGDR L-shaped; CMM risk decreasing until inflection point 11.82, HR
- 0.758 (0.702-0.818) (95% CI)
- TyG-WC U-shaped, inflection point
- 572.14
Predictive discrimination (time-dependent AUC)
- eGDR superior predictive discrimination during early follow-up and across all intervals, AUC
- 0.68-0.76
- Optimal eGDR cut-off
- 7.64
Original publication
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