The effects of estimated glucose disposal rate and high sensitivity C-reactive protein on risk of incident cardiovascular diseases in middle-aged and elderly Chinese adults: a nationwide prospective cohort study

Abstract Aim Cardiovascular diseases (CVD) remain the predominant contributor to global mortality and morbidity, necessitating enhanced strategies for primary prevention and early detection. This investigation sought to characterize the associations between estimated glucose disposal rate (eGDR), hi...

Full description

Saved in:
Bibliographic Details
Main Authors: Linghao Xu, Jiangping Ma, Yong Xu
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Lipids in Health and Disease
Subjects:
Online Access:https://doi.org/10.1186/s12944-025-02653-z
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849331571225526272
author Linghao Xu
Jiangping Ma
Yong Xu
author_facet Linghao Xu
Jiangping Ma
Yong Xu
author_sort Linghao Xu
collection DOAJ
description Abstract Aim Cardiovascular diseases (CVD) remain the predominant contributor to global mortality and morbidity, necessitating enhanced strategies for primary prevention and early detection. This investigation sought to characterize the associations between estimated glucose disposal rate (eGDR), high sensitivity C-reactive protein (hsCRP), and incident CVD. Methods The research used data from China Health and Retirement Longitudinal Study (CHARLS). The primary exposures included eGDR and hsCRP. Incident CVD served as the primary study endpoint. All statistical analyses were performed utilizing SPSS software (version 25.0) and R software (version 4.4.4). Results The analysis of 7,742 participants revealed incident CVD in 1,981 cases (25.6%), with Kaplan–Meier curves demonstrating significantly elevated cumulative incidence among individuals exhibiting both reduced eGDR and elevated hsCRP levels. Significant interactions were observed between these biomarkers, including an additive effect (relative excess risk due to interaction = 0.09, 95% confidence interval [CI]: 0.03–0.14) and a multiplicative effect (hazard ratio = 1.02, 95% CI: 1.01–1.03). Mediation analyses indicated bidirectional relationships, with eGDR accounting for 5.81% (95% CI: 2.13–9.49%) of the hsCRP-CVD association and hsCRP mediating 8.52% (95% CI: 3.87–13.17%) of the eGDR-CVD relationship. Notably, in individuals with diabetes, the combined predictive capacity of eGDR and hsCRP (area under the curve: 0.645) demonstrated superior discriminative performance compared to either biomarker alone (AUC: 0.645). Conclusion eGDR and hsCRP exert significant joint, interactive and mediating effects on incident CVD in middle-aged and elderly Chinese population. Using eGDR (10.52 mg/kg/min) and hsCRP (1 mg/L) thresholds can be an affordable screening tool in primary care, especially where advanced diagnostics are lacking. Incorporating these assessments into regular check-ups may lower long-term CVD complications and reduce economic burdens.
format Article
id doaj-art-9eb6e5738a2b40edbb611c8a0e1cc7e9
institution Kabale University
issn 1476-511X
language English
publishDate 2025-07-01
publisher BMC
record_format Article
series Lipids in Health and Disease
spelling doaj-art-9eb6e5738a2b40edbb611c8a0e1cc7e92025-08-20T03:46:29ZengBMCLipids in Health and Disease1476-511X2025-07-0124111010.1186/s12944-025-02653-zThe effects of estimated glucose disposal rate and high sensitivity C-reactive protein on risk of incident cardiovascular diseases in middle-aged and elderly Chinese adults: a nationwide prospective cohort studyLinghao Xu0Jiangping Ma1Yong Xu2Department of Endocrinology and Metabolism, the Affiliated Hospital of Southwest Medical University, Luzhou Department of Neurology, Tongren Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrinology and Metabolism, the Affiliated Hospital of Southwest Medical University, Luzhou Abstract Aim Cardiovascular diseases (CVD) remain the predominant contributor to global mortality and morbidity, necessitating enhanced strategies for primary prevention and early detection. This investigation sought to characterize the associations between estimated glucose disposal rate (eGDR), high sensitivity C-reactive protein (hsCRP), and incident CVD. Methods The research used data from China Health and Retirement Longitudinal Study (CHARLS). The primary exposures included eGDR and hsCRP. Incident CVD served as the primary study endpoint. All statistical analyses were performed utilizing SPSS software (version 25.0) and R software (version 4.4.4). Results The analysis of 7,742 participants revealed incident CVD in 1,981 cases (25.6%), with Kaplan–Meier curves demonstrating significantly elevated cumulative incidence among individuals exhibiting both reduced eGDR and elevated hsCRP levels. Significant interactions were observed between these biomarkers, including an additive effect (relative excess risk due to interaction = 0.09, 95% confidence interval [CI]: 0.03–0.14) and a multiplicative effect (hazard ratio = 1.02, 95% CI: 1.01–1.03). Mediation analyses indicated bidirectional relationships, with eGDR accounting for 5.81% (95% CI: 2.13–9.49%) of the hsCRP-CVD association and hsCRP mediating 8.52% (95% CI: 3.87–13.17%) of the eGDR-CVD relationship. Notably, in individuals with diabetes, the combined predictive capacity of eGDR and hsCRP (area under the curve: 0.645) demonstrated superior discriminative performance compared to either biomarker alone (AUC: 0.645). Conclusion eGDR and hsCRP exert significant joint, interactive and mediating effects on incident CVD in middle-aged and elderly Chinese population. Using eGDR (10.52 mg/kg/min) and hsCRP (1 mg/L) thresholds can be an affordable screening tool in primary care, especially where advanced diagnostics are lacking. Incorporating these assessments into regular check-ups may lower long-term CVD complications and reduce economic burdens.https://doi.org/10.1186/s12944-025-02653-zCardiovascular diseasesEstimated glucose disposal rateHigh sensitivity C-reactive proteinCohort studiesChina
spellingShingle Linghao Xu
Jiangping Ma
Yong Xu
The effects of estimated glucose disposal rate and high sensitivity C-reactive protein on risk of incident cardiovascular diseases in middle-aged and elderly Chinese adults: a nationwide prospective cohort study
Lipids in Health and Disease
Cardiovascular diseases
Estimated glucose disposal rate
High sensitivity C-reactive protein
Cohort studies
China
title The effects of estimated glucose disposal rate and high sensitivity C-reactive protein on risk of incident cardiovascular diseases in middle-aged and elderly Chinese adults: a nationwide prospective cohort study
title_full The effects of estimated glucose disposal rate and high sensitivity C-reactive protein on risk of incident cardiovascular diseases in middle-aged and elderly Chinese adults: a nationwide prospective cohort study
title_fullStr The effects of estimated glucose disposal rate and high sensitivity C-reactive protein on risk of incident cardiovascular diseases in middle-aged and elderly Chinese adults: a nationwide prospective cohort study
title_full_unstemmed The effects of estimated glucose disposal rate and high sensitivity C-reactive protein on risk of incident cardiovascular diseases in middle-aged and elderly Chinese adults: a nationwide prospective cohort study
title_short The effects of estimated glucose disposal rate and high sensitivity C-reactive protein on risk of incident cardiovascular diseases in middle-aged and elderly Chinese adults: a nationwide prospective cohort study
title_sort effects of estimated glucose disposal rate and high sensitivity c reactive protein on risk of incident cardiovascular diseases in middle aged and elderly chinese adults a nationwide prospective cohort study
topic Cardiovascular diseases
Estimated glucose disposal rate
High sensitivity C-reactive protein
Cohort studies
China
url https://doi.org/10.1186/s12944-025-02653-z
work_keys_str_mv AT linghaoxu theeffectsofestimatedglucosedisposalrateandhighsensitivitycreactiveproteinonriskofincidentcardiovasculardiseasesinmiddleagedandelderlychineseadultsanationwideprospectivecohortstudy
AT jiangpingma theeffectsofestimatedglucosedisposalrateandhighsensitivitycreactiveproteinonriskofincidentcardiovasculardiseasesinmiddleagedandelderlychineseadultsanationwideprospectivecohortstudy
AT yongxu theeffectsofestimatedglucosedisposalrateandhighsensitivitycreactiveproteinonriskofincidentcardiovasculardiseasesinmiddleagedandelderlychineseadultsanationwideprospectivecohortstudy
AT linghaoxu effectsofestimatedglucosedisposalrateandhighsensitivitycreactiveproteinonriskofincidentcardiovasculardiseasesinmiddleagedandelderlychineseadultsanationwideprospectivecohortstudy
AT jiangpingma effectsofestimatedglucosedisposalrateandhighsensitivitycreactiveproteinonriskofincidentcardiovasculardiseasesinmiddleagedandelderlychineseadultsanationwideprospectivecohortstudy
AT yongxu effectsofestimatedglucosedisposalrateandhighsensitivitycreactiveproteinonriskofincidentcardiovasculardiseasesinmiddleagedandelderlychineseadultsanationwideprospectivecohortstudy