Lipids & metabolic liver disease
Burden trajectories of stroke attributable to lipid-glucose dysfunction and biomarker validation: evidence from the global burden of disease (GBD) 2023 and the China health and retirement longitudinal study (CHARLS)
Authors' conclusion
Age-standardized stroke burden attributable to high FPG and high LDL-C in China has declined, but the absolute burden remains substantial. eGDR showed consistent associations with incident stroke and modest incremental predictive value across CHARLS and HRS, supporting its potential relevance for future stroke risk-stratification research.
Study context
- Population
- China, GBD 2023 (1990–2023); CHARLS (2011–2020) discovery cohort and HRS (2016–2022) external-validation cohort
- Comparison
- Lipid-glucose metabolic biomarkers (eGDR) for incident stroke; stroke burden attributable to high FPG and high LDL-C
Methodological detailsCHARLS discovery, HRS external validation, machine learning with SHAP interpretation, Cox proportional hazards models, FDR correction
- CHARLS discovery, HRS external validation
- Machine learning with SHAP interpretation
- Cox proportional hazards models
- FDR correction
Primary result
As reported in the abstract
2023
| Group | Value | DALYs |
|---|---|---|
| High FPG | 216.80 thousand stroke deaths | 4,378.51 thousand |
| High LDL-C | 233.09 thousand deaths | 5,642.72 thousand |
Value
High FPG216.80 thousand stroke deaths
High LDL-C233.09 thousand deaths
DALYs
High FPG4,378.51 thousand
High LDL-C5,642.72 thousand
Further findings
eGDR and incident stroke
- AUC improvement adding eGDR to conventional clinical risk models, CHARLS
- 0.017-0.025
- AUC improvement adding eGDR to conventional clinical risk models, HRS
- 0.009-0.013
- In CHARLS, eGDR showed a consistent inverse association with stroke risk and ranked as the leading predictor in SHAP analyses; similar patterns in HRS
- Modestly improved discrimination and reclassification in both cohorts
Original publication
Burden trajectories of stroke attributable to lipid-glucose dysfunction and biomarker validation: evidence from the global burden of disease (GBD) 2023 and the China health and retirement longitudinal study (CHARLS). Cardiovasc Diabetol. Published 22 June 2026. doi:10.
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