Lipids & metabolic liver disease
Cumulative estimated glucose disposal rate and longitudinal estimated glucose disposal rate (eGDR) patterns in relation to incident cardiovascular disease among middle-aged and older adults with metabolic dysfunction-associated steatotic liver disease: a prospective cohort study
Authors' conclusion
Among middle-aged and older Chinese adults meeting an operational TyG-WC-based MASLD definition, lower cumulative eGDR and longitudinal eGDR patterns characterised by low levels at both observed measurements or a marked decline between measurements were associated with a higher risk of incident CVD.
Study context
- Population
- Adults aged ≥45 years in 2011 meeting an operational TyG-WC-based MASLD definition, with eGDR in 2011 and 2015, alive and free of cardiovascular disease (CVD) at 2015 landmark; China457 incident CVD
- Participants
- 2,059 adults
- Exposure
- Lower vs higher cumulative eGDR; longitudinal eGDR patterns
- Outcome
- Incident CVD: first report of physician-diagnosed heart disease or stroke
- Follow-up
- 2015 to 2020
Methodological detailslandmark analysis (2015), China Health and Retirement Longitudinal Study, exploratory K-means clustering of longitudinal eGDR patterns
- Landmark analysis (2015)
- China Health and Retirement Longitudinal Study
- Exploratory K-means clustering of longitudinal eGDR patterns
Main finding
As reported in the abstract
Incident CVD by cumulative eGDR
Hazard ratio (95% CI)P value
Per 1-SD lower cumulative eGDRfully adjusted
1.39(1.26–1.55)
Q4vs Q1
2.40(1.77–3.25)
P < 0.001for trend- Dose-response approximately linear
- P for non-linearity = 0.915
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Incident CVD by longitudinal eGDR patternModerate-low eGDR-slight risevs High eGDR-slight declineExploratory patterns | 1.43 (1.07–1.90) | |
| Incident CVD by longitudinal eGDR patternHigh eGDR-marked declinevs High eGDR-slight declineExploratory patterns | 1.64 (1.20–2.23) | |
| Incident CVD by longitudinal eGDR patternLow eGDR-slight declinevs High eGDR-slight declineExploratory patterns | 2.14 (1.67–2.74) | |
| 0.20.5125Hazard ratio (log scale) |
| Outcome | ΔC-index (95% CI) | |
|---|---|---|
| Incremental discrimination (paired out-of-bag C-index)Conventional model + cumulative eGDRvs Conventional risk-factor model | 0.033 (0.009–0.056) | |
| −0.0500.050.1Difference (linear scale) |
| Outcome | ΔC-index (95% CI) |
|---|---|
| Incremental discrimination (paired out-of-bag C-index)Model with 2015 eGDR + cumulative eGDR vs Model with 2015 eGDR | - 0.001 (- 0.007 to 0.006) |
Heart disease and stroke
- Lower cumulative eGDR also associated with higher risks of heart disease and stroke
Original publication
Cumulative estimated glucose disposal rate and longitudinal eGDR patterns in relation to incident cardiovascular disease among middle-aged and older adults with metabolic dysfunction-associated steatotic liver disease: a prospective cohort study. Cardiovasc Diabetol. Published 30 September 2026. doi:10.
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