Association between estimated glucose disposal rate and subclinical cerebrovascular atherosclerotic burden in non-diabetic middle-aged and older adults
- 1Department of Neurology, Xindu District People’s Hospital of Chengdu
- 2Shi Ban Tan Community Healthcare Center
- 3Department of Endocrinology, Xindu District People’s Hospital of Chengdu
Abstract
Objective: To evaluate the association and dose–response relationship between estimated glucose disposal rate (eGDR), a surrogate marker of insulin resistance, and subclinical cerebrovascular atherosclerotic burden in non-diabetic middle-aged and older adults.
Methods: This retrospective analysis used data from a prospective registry and included 604 adults aged ≥45 years without diabetes. Participants with symptomatic cerebrovascular disease, including prior ischemic stroke or transient ischemic attack attributable to cerebrovascular stenosis, were excluded. Cerebrovascular atherosclerosis was assessed using carotid duplex ultrasonography, head and neck magnetic resonance angiography, or head and neck computed tomography angiography. Based on neuroimaging results, participants were classified into three categories: no atherosclerosis, single vascular bed involvement, and dual vascular bed involvement. Associations between eGDR and atherosclerotic burden were evaluated using ordinal logistic regression models, including unadjusted, age- and sex-adjusted, and fully adjusted models. Restricted cubic spline (RCS) analysis was performed to examine the dose–response relationship.
Results: All 604 participants were community-dwelling adults without symptomatic cerebrovascular disease. The mean age was 64 ± 11 years, and 220 (36.4%) were male. Participants with a higher subclinical cerebrovascular atherosclerotic burden were older, had a higher prevalence of hypertension, and had lower eGDR levels ( p < 0.001). The prevalence of single and dual vascular bed involvement decreased progressively across eGDR quartiles, from the lowest (Q1) to the highest (Q4) quartile (single bed: 33.1% vs. 19.2%; dual beds: 13.2% vs. 2.0%). In the fully adjusted ordinal logistic regression model, each 1-SD increase in eGDR was associated with lower odds of being in a higher atherosclerotic burden category (OR = 0.74, 95% CI: 0.62–0.89, p = 0.001). Compared with Q1, participants in Q4 had lower odds of being in a higher burden category (OR = 0.42, 95% CI: 0.24–0.72, p = 0.001; P for trend = 0.002). The RCS analysis showed a linear correlation between eGDR and atherosclerotic burden (overall p = 0.002, non-linear p = 0.322).
Conclusion: Among middle-aged and older adults without diabetes, lower eGDR was independently associated with a higher subclinical cerebrovascular atherosclerotic burden, with a linear pattern. These findings warrant further investigation in prospective studies.
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BibTeX
@article{guo2026association,
title = {{Association between estimated glucose disposal rate and subclinical cerebrovascular atherosclerotic burden in non-diabetic middle-aged and older adults}},
author = {Lei Guo and Yubo Zhao and Meng Qu and Ming Li and Jianchun Zhu and Sha Zheng and Jun Zhang},
journal = {Frontiers in Neurology},
year = {2026},
month = oct,
doi = {10.3389/fneur.2026.1946802},
url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1946802/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association between estimated glucose disposal rate and subclinical cerebrovascular atherosclerotic burden in non-diabetic middle-aged and older adults
AU - Lei Guo
AU - Yubo Zhao
AU - Meng Qu
AU - Ming Li
AU - Jianchun Zhu
AU - Sha Zheng
AU - Jun Zhang
PY - 2026
DA - 2026/10/20
JO - Frontiers in Neurology
DO - 10.3389/fneur.2026.1946802
UR - https://www.frontiersin.org/articles/10.3389/fneur.2026.1946802/full
AB - Objective: To evaluate the association and dose–response relationship between estimated glucose disposal rate (eGDR), a surrogate marker of insulin resistance, and subclinical cerebrovascular atherosclerotic burden in non-diabetic middle-aged and older adults. Methods: This retrospective analysis used data from a prospective registry and included 604 adults aged ≥45 years without diabetes. Participants with symptomatic cerebrovascular disease, including prior ischemic stroke or transient ischemic attack attributable to cerebrovascular stenosis, were excluded. Cerebrovascular atherosclerosis was assessed using carotid duplex ultrasonography, head and neck magnetic resonance angiography, or head and neck computed tomography angiography. Based on neuroimaging results, participants were classified into three categories: no atherosclerosis, single vascular bed involvement, and dual vascular bed involvement. Associations between eGDR and atherosclerotic burden were evaluated using ordinal logistic regression models, including unadjusted, age- and sex-adjusted, and fully adjusted models. Restricted cubic spline (RCS) analysis was performed to examine the dose–response relationship. Results: All 604 participants were community-dwelling adults without symptomatic cerebrovascular disease. The mean age was 64 ± 11 years, and 220 (36.4%) were male. Participants with a higher subclinical cerebrovascular atherosclerotic burden were older, had a higher prevalence of hypertension, and had lower eGDR levels ( p < 0.001). The prevalence of single and dual vascular bed involvement decreased progressively across eGDR quartiles, from the lowest (Q1) to the highest (Q4) quartile (single bed: 33.1% vs. 19.2%; dual beds: 13.2% vs. 2.0%). In the fully adjusted ordinal logistic regression model, each 1-SD increase in eGDR was associated with lower odds of being in a higher atherosclerotic burden category (OR = 0.74, 95% CI: 0.62–0.89, p = 0.001). Compared with Q1, participants in Q4 had lower odds of being in a higher burden category (OR = 0.42, 95% CI: 0.24–0.72, p = 0.001; P for trend = 0.002). The RCS analysis showed a linear correlation between eGDR and atherosclerotic burden (overall p = 0.002, non-linear p = 0.322). Conclusion: Among middle-aged and older adults without diabetes, lower eGDR was independently associated with a higher subclinical cerebrovascular atherosclerotic burden, with a linear pattern. These findings warrant further investigation in prospective studies.
SN - 1664-2295
ER -