Cardiovascular diabetology. Endocrinology reports · 2026
Estimated glucose disposal rate and risk of first myocardial infarction in people with diabetes.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Glynn Linn, Persson Martina, Andersson Tomas, Hofmann Robin, Nyström Thomas
Аннотация
BACKGROUND: The estimated glucose disposal rate (eGDR), calculated from glycated hemoglobin (HbA1c), hypertension status and BMI, is a proxy for insulin resistance. We examined the association between eGDR and the risk of first myocardial infarction (MI) and post-MI mortality in individuals with type 1 and type 2 diabetes.
METHODS: Using nationwide health registry data (2006-2020), we identified individuals with type 1 and type 2 diabetes. Follow-up started at the first time a complete eGDR could be calculated. eGDR was then handled as a time-updated exposure until first MI, with person-time assigned according to the most recent available value. Among those with MI, follow-up for post-MI mortality started at the event, and covariates were fixed at their last value before MI. Hazard ratios (HRs) with 95% CIs were estimated using Cox regression with adjustment for blood lipids, albuminuria, estimated glomerular filtration rate and physical activity.
RESULTS: We included 46,155 individuals with type 1 diabetes and 570,230 individuals with type 2 diabetes (both 43% women). During a median follow up of 7.7 person-years, 1997 (4.3%) and 34,237 (6.0%) experienced first MI, respectively. Adjusted HRs (95% CIs) for first MI across eGDR categories ≤4, 4-6, 6-8, and ≥8 mg/kg/min) were: 3.73 (3.35-4.16), 3.09 (2.85-3.35), 2.40 (2.15-2.69) and 0.96 (0.79-1.17) for type 1 diabetes, respectively. Corresponding HRs for type 2 diabetes were 1.71 (1.62-1.82), 1.54 (1.46-1.62), 1.43 (1.35-1.51) and 1 (reference). Similar associations were observed for post-MI mortality, however non-significant across all eGDR categories.
CONCLUSIONS: Lower eGDR, reflecting greater insulin resistance, was associated with a higher risk of first MI, with a stronger association observed in type 1 diabetes. These findings support insulin resistance as a potential modifiable cardiovascular risk factor in people with diabetes.
METHODS: Using nationwide health registry data (2006-2020), we identified individuals with type 1 and type 2 diabetes. Follow-up started at the first time a complete eGDR could be calculated. eGDR was then handled as a time-updated exposure until first MI, with person-time assigned according to the most recent available value. Among those with MI, follow-up for post-MI mortality started at the event, and covariates were fixed at their last value before MI. Hazard ratios (HRs) with 95% CIs were estimated using Cox regression with adjustment for blood lipids, albuminuria, estimated glomerular filtration rate and physical activity.
RESULTS: We included 46,155 individuals with type 1 diabetes and 570,230 individuals with type 2 diabetes (both 43% women). During a median follow up of 7.7 person-years, 1997 (4.3%) and 34,237 (6.0%) experienced first MI, respectively. Adjusted HRs (95% CIs) for first MI across eGDR categories ≤4, 4-6, 6-8, and ≥8 mg/kg/min) were: 3.73 (3.35-4.16), 3.09 (2.85-3.35), 2.40 (2.15-2.69) and 0.96 (0.79-1.17) for type 1 diabetes, respectively. Corresponding HRs for type 2 diabetes were 1.71 (1.62-1.82), 1.54 (1.46-1.62), 1.43 (1.35-1.51) and 1 (reference). Similar associations were observed for post-MI mortality, however non-significant across all eGDR categories.
CONCLUSIONS: Lower eGDR, reflecting greater insulin resistance, was associated with a higher risk of first MI, with a stronger association observed in type 1 diabetes. These findings support insulin resistance as a potential modifiable cardiovascular risk factor in people with diabetes.