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Background <p>Prior studies have suggested an association between estimated glucose disposal rate (eGDR) and the risk of incident stroke in nondiabetic populations. However, evidence regarding the impact of long-term cumulative exposure to eGDR on stroke risk remains limited. This study aimed to investigate whether cumulative eGDR levels are independently associated with incident stroke among adults aged 50&#xa0;years and older without diabetes.</p> Methods <p>We used data from the China Health and Retirement Longitudinal Study (CHARLS) and included 3,808 participants aged 50&#xa0;years or older with no history of diabetes. Cumulative eGDR was calculated as the sum of the products of the average eGDR between consecutive survey waves and the corresponding time interval in years. The primary outcome was incident stroke. Associations between cumulative eGDR and stroke risk were assessed using Cox proportional hazards regression and restricted cubic spline (RCS) models. Discriminatory performance was assessed using receiver-operating characteristic (ROC) curves.</p> Results <p>The median age at baseline was 61&#xa0;years, and 48.7% of participants were men. RCS analyses revealed a significant inverse and nonlinear association between cumulative eGDR and incident stroke (<i>P</i> &lt; 0.001; <i>P</i> for nonlinearity = 0.021). After adjustment for potential confounders, higher cumulative eGDR was independently associated with a reduced risk of stroke (per standard deviation increase: HR: 0.69; 95% CI, 0.60–0.80; <i>P</i> &lt; 0.001). Quartile-based analysis of cumulative eGDR further demonstrated that, compared with participants in the lowest quartile, those in the second quartile (Q2: HR: 0.63; 95% CI, 0.46–0.88; <i>P</i> = 0.006), third quartile (Q3: HR: 0.41; 95% CI, 0.28–0.60; <i>P</i> &lt; 0.001) and fourth quartile (Q4: HR: 0.35; 95% CI, 0.23–0.52; <i>P</i> &lt; 0.001) had significantly lower risks of incident stroke.</p> Conclusions <p>Among adults aged 50&#xa0;years or older without diabetes, lower cumulative eGDR levels were significantly associated with an increased risk of incident stroke.</p> Graphical Abstract <p></p>

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Association between the cumulative estimated glucose disposal rate and incident stroke in adults aged 50 and above without diabetes: a prospective nationwide cohort study in China

  • 期刊论文

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  • 发表日期：

    2025年12月19日

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  • Ran Yan,
  • Yawen Yin,
  • Yizhen Hu,
  • Juxiang Yang,
  • Jindong Chang,
  • Yi Wang,
  • Gang Song

摘要

Background

Prior studies have suggested an association between estimated glucose disposal rate (eGDR) and the risk of incident stroke in nondiabetic populations. However, evidence regarding the impact of long-term cumulative exposure to eGDR on stroke risk remains limited. This study aimed to investigate whether cumulative eGDR levels are independently associated with incident stroke among adults aged 50 years and older without diabetes.

Methods

We used data from the China Health and Retirement Longitudinal Study (CHARLS) and included 3,808 participants aged 50 years or older with no history of diabetes. Cumulative eGDR was calculated as the sum of the products of the average eGDR between consecutive survey waves and the corresponding time interval in years. The primary outcome was incident stroke. Associations between cumulative eGDR and stroke risk were assessed using Cox proportional hazards regression and restricted cubic spline (RCS) models. Discriminatory performance was assessed using receiver-operating characteristic (ROC) curves.

Results

The median age at baseline was 61 years, and 48.7% of participants were men. RCS analyses revealed a significant inverse and nonlinear association between cumulative eGDR and incident stroke (P < 0.001; P for nonlinearity = 0.021). After adjustment for potential confounders, higher cumulative eGDR was independently associated with a reduced risk of stroke (per standard deviation increase: HR: 0.69; 95% CI, 0.60–0.80; P < 0.001). Quartile-based analysis of cumulative eGDR further demonstrated that, compared with participants in the lowest quartile, those in the second quartile (Q2: HR: 0.63; 95% CI, 0.46–0.88; P = 0.006), third quartile (Q3: HR: 0.41; 95% CI, 0.28–0.60; P < 0.001) and fourth quartile (Q4: HR: 0.35; 95% CI, 0.23–0.52; P < 0.001) had significantly lower risks of incident stroke.

Conclusions

Among adults aged 50 years or older without diabetes, lower cumulative eGDR levels were significantly associated with an increased risk of incident stroke.

Graphical Abstract