Diabetes Res Clin Pract. 2026 Apr 9:113258. doi: 10.1016/j.diabres.2026.113258. Online ahead of print.
ABSTRACT
BACKGROUND: Estimated glucose disposal rate (eGDR) and frailty index (FI) captures insulin resistance and multisystem decline, respectively. However, the combined prognostic value of eGDR and FI for cardiovascular diseases (CVD) and mortality remains underexplored.
METHODS: This prospective cohort study included 6,684 participants from the CHARLS. The composite index eGDRFI was calculated as FI/eGDR. The study endpoints were incident CVD, stroke, heart disease, and all-cause mortality.
RESULTS: After adjustment, each 1-unit increase in eGDRFI was significantly associated with higher risks of CVD (HR = 1.098, 95% CI 1.061-1.136) and all-cause mortality (HR = 1.080, 95% CI 1.048-1.113) (both P < 0.001). Compared to the lowest quartile (Q1), participants in the highest eGDRFI quartile (Q4) had markedly increased risks of CVD (HR = 1.833, 95% CI 1.494-2.249) and mortality (HR = 1.511, 95% CI 1.212-1.884) (both P < 0.001). ROC curve analysis demonstrated that eGDRFI achieved higher discriminative ability for predicting incident CVD (AUC = 0.600) compared to eGDR (AUC = 0.590) and FI (AUC = 0.563), as well as for predicting all-cause mortality (eGDRFI AUC = 0.606 vs. eGDR 0.547 and FI 0.601).
CONCLUSION: The combined eGDRFI is a robust predictor of cardiovascular events and mortality in middle-aged and older adults, and may serve as a practical tool for risk stratification.
PMID:41966280 | DOI:10.1016/j.diabres.2026.113258