The role of cardiovascular disease in the association between estimated glucose disposal rate and chronic kidney disease.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE

Original Publication: London : Nature Publishing Group, copyright 2011-

Renal Insufficiency, Chronic*/epidemiology ; Renal Insufficiency, Chronic*/metabolism ; Renal Insufficiency, Chronic*/etiology ; Cardiovascular Diseases*/complications ; Cardiovascular Diseases*/epidemiology ; Cardiovascular Diseases*/metabolism ; Blood Glucose*/metabolism ; Glucose*/metabolism; Humans ; Male ; Female ; Aged ; Middle Aged ; China/epidemiology ; Longitudinal Studies ; Risk Factors ; Insulin Resistance ; Incidence ; Proportional Hazards Models

Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethical approval: The CHARLS study received approval from the Institutional Review Board of Peking University (approval numbers: IRB00001052-11015 for household surveys and IRB00001052-11014 for blood samples), with written informed consent obtained from all participants.
Chronic kidney disease (CKD) is characterized as a progressive dysfunction of the kidney. The estimated glucose disposal rate (eGDR) is widely recognized as a dependable marker of insulin resistance (IR). Nonetheless, the potential link between eGDR and CKD incidence remains insufficiently clarified. This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS). The outcome of this study was CKD events. We performed adjusted Cox proportional hazards regression, restricted cubic splines (RCS), and mediation analyses. Among the 6,737 participants followed for a median of 108 months, 1,356 (20.13%) developed CKD. Relative to the lowest quartile (Q1) of eGDR, the adjusted HR for the highest quartile (Q4) was 0.85 (95% CI: 0.72-0.99). Each standard deviation increase in eGDR was linked to a 7% reduction in CKD risk (HR: 0.93, 95% CI: 0.88-0.99). The RCS curve indicated a linear relationship between eGDR and CKD risk (threshold = 8.21). The cardiovascular disease (CVD) significantly mediated 27.0% of the association between eGDR and CKD risk. This study demonstrates a significant inverse correlation between eGDR levels and CKD risk in middle-aged and elderly individuals within the Chinese population. Moreover, CVD emerges as a key intermediary linking eGDR and the heightened risk of CKD.
(© 2025. The Author(s).)

Am J Physiol Renal Physiol. 2016 Dec 1;311(6):F1087-F1108. (PMID: 27707707)
Nephron. 2022;146(3):302-305. (PMID: 34167119)
Kidney Int. 2011 Jun;79(12):1341-52. (PMID: 21307840)
Endocr Rev. 2019 Dec 1;40(6):1447-1467. (PMID: 31050706)
Nutrients. 2021 Dec 02;13(12):. (PMID: 34959901)
Lancet. 2020 Feb 29;395(10225):709-733. (PMID: 32061315)
Stat Med. 1992 Jul;11(10):1273-87. (PMID: 1518991)
Int J Epidemiol. 2014 Feb;43(1):61-8. (PMID: 23243115)
Nephrol Dial Transplant. 2022 Jan 25;37(2):239-254. (PMID: 34264297)
J Int Med Res. 2023 Mar;51(3):3000605231164548. (PMID: 36994866)
J Hypertens. 2022 Nov 1;40(11):2292-2298. (PMID: 35950988)
Kidney Int. 2014 Aug;86(2):243-5. (PMID: 25079023)
Nat Rev Nephrol. 2022 Nov;18(11):696-707. (PMID: 36104509)
Curr Cardiol Rev. 2019;15(1):55-63. (PMID: 29992892)
Atherosclerosis. 2018 Nov;278:49-59. (PMID: 30253289)
Biomolecules. 2020 Sep 09;10(9):. (PMID: 32917052)
Stat Med. 2012 Jan 30;31(2):101-13. (PMID: 22147389)
Kidney Int Suppl (2011). 2022 Apr;12(1):7-11. (PMID: 35529086)
Eur Rev Med Pharmacol Sci. 2014 Oct;18(19):2918-26. (PMID: 25339487)
Lancet Glob Health. 2016 May;4(5):e307-19. (PMID: 27102194)
Lancet. 2021 Aug 28;398(10302):786-802. (PMID: 34175022)
Eur Respir J. 2021 Nov 4;58(5):. (PMID: 34503984)
Diabet Med. 2009 Feb;26(2):177-81. (PMID: 19236623)
Diabetes Metab J. 2022 Jan;46(1):15-37. (PMID: 34965646)
Lancet. 2007 Oct 20;370(9596):1453-7. (PMID: 18064739)
Eat Weight Disord. 2018 Apr;23(2):149-157. (PMID: 29397563)
Eur J Vasc Endovasc Surg. 2015 Apr;49(4):465-73. (PMID: 25725508)
Nutr Clin Pract. 1988 Oct;3(5):171-2. (PMID: 3193952)
Metabolism. 2021 Jun;119:154766. (PMID: 33766485)
Kidney Int. 1992 Nov;42(5):1160-8. (PMID: 1453601)
Diabetes Obes Metab. 2018 Mar;20(3):556-563. (PMID: 28884949)
Nephrol Dial Transplant. 2024 Jun 28;39(7):1150-1158. (PMID: 38168720)
Clin Exp Hypertens. 2023 Dec 31;45(1):2175849. (PMID: 36823499)
Nephrol Dial Transplant. 2017 Aug 1;32(8):1274-1281. (PMID: 26374599)
J Cardiovasc Dev Dis. 2024 Aug 26;11(9):. (PMID: 39330319)
Clin Nephrol. 2000 Nov;54(5):366-73. (PMID: 11105797)
Am J Physiol. 1979 Sep;237(3):E214-23. (PMID: 382871)
Mayo Clin Proc. 2022 Oct;97(10):1883-1893. (PMID: 35760597)
Cardiovasc Diabetol. 2024 Jun 6;23(1):194. (PMID: 38844981)
Cardiovasc Diabetol. 2018 Aug 31;17(1):122. (PMID: 30170598)
Ann Intern Med. 2017 Aug 15;167(4):268-274. (PMID: 28693043)
Lancet. 2012 Mar 3;379(9818):815-22. (PMID: 22386035)
Eur Heart J. 2018 Sep 1;39(33):3021-3104. (PMID: 30165516)
Kidney Int. 2011 Jul;80(1):93-104. (PMID: 21289597)
J Am Soc Nephrol. 2003 Feb;14(2):469-77. (PMID: 12538749)
Diabetol Metab Syndr. 2022 Oct 6;14(1):145. (PMID: 36203208)
J Nutr Metab. 2017;2017:6425359. (PMID: 28392941)
Circulation. 2023 Nov 14;148(20):1606-1635. (PMID: 37807924)
Can J Cardiol. 2020 May;36(5):671-682. (PMID: 32389340)
Am J Kidney Dis. 2009 Jun;53(6):982-92. (PMID: 19339088)
J Am Med Dir Assoc. 2015 Apr;16(4):349.e1-5. (PMID: 25669668)
PLoS Med. 2012;9(11):e1001344. (PMID: 23185136)
Nephrol Dial Transplant. 2013 Jan;28(1):29-36. (PMID: 23048172)
Diabetes Care. 2013 Oct;36(10):3195-200. (PMID: 23735722)

BXQN2023016 Boxi Youth Natural Science Foundation; BXQN2023016 Boxi Youth Natural Science Foundation; BXQN2023016 Boxi Youth Natural Science Foundation; BXQN2023016 Boxi Youth Natural Science Foundation; BXQN2023016 Boxi Youth Natural Science Foundation; BXQN2023016 Boxi Youth Natural Science Foundation; M20220 Scientific Research Project of Jiangsu Commission of Health; M20220 Scientific Research Project of Jiangsu Commission of Health; M20220 Scientific Research Project of Jiangsu Commission of Health; M20220 Scientific Research Project of Jiangsu Commission of Health; M20220 Scientific Research Project of Jiangsu Commission of Health; M20220 Scientific Research Project of Jiangsu Commission of Health; SKY2022131 Medical Innovation Application Research Project of Suzhou Science and Technology Bureau; SKY2022131 Medical Innovation Application Research Project of Suzhou Science and Technology Bureau; SKY2022131 Medical Innovation Application Research Project of Suzhou Science and Technology Bureau; SKY2022131 Medical Innovation Application Research Project of Suzhou Science and Technology Bureau; SKY2022131 Medical Innovation Application Research Project of Suzhou Science and Technology Bureau; SKY2022131 Medical Innovation Application Research Project of Suzhou Science and Technology Bureau

Keywords: CHARLS; Cardiovascular disease; Chronic kidney disease; Estimated glucose disposal rate; Insulin resistance

0 (Blood Glucose)
IY9XDZ35W2 (Glucose)

Date Created: 20250509 Date Completed: 20250509 Latest Revision: 20250511

20250511

PMC12062300

10.1038/s41598-025-00359-x

40341196