Association of estimated glucose disposal rate and body mass index with stroke risk in middle-aged and elderly populations: evidence from two cohort studies

Abstract Background Estimated Glucose Disposal Rate (eGDR) is one of the markers of insulin resistance (IR). However, current literature lacks robust evidence to clarify the correlation between eGDR-Body Mass Index (eGDR-BMI) and stroke incidence. Therefore, this study aims to explore the potential relationship between eGDR-BMI and stroke risk. Methods This study analyzed data from the National Health and Nutrition Examination Survey (NHANES) and the China Health and Retirement Longitudinal Study (CHARLS). A multivariable logistic regression model was applied to examine the association between eGDR-BMI and stroke risk. Restricted cubic splines (RCS) were employed to explore the dose-response relationship and non-linear association between eGDR-BMI and stroke risk. The predictive performance of the models was evaluated using Receiver Operating Characteristic (ROC) curves and Decision Curve Analysis (DCA). Results A total of 18,837 participants were included (CHARLS: 9,202; NHANES: 9,635). Multivariable-adjusted analyses demonstrated that eGDR-BMI was independently associated with reduced stroke risk. Each 1-SD increase in eGDR-BMI corresponded to an 8.7% risk reduction (HR = 0.913; 95% CI: 0.786–0.990; p