Insulin resistance evaluated by estimated glucose disposal rate and its association with cardiometabolic risk factors among adolescents in Northeast China

Abstract

Background Insulin resistance (IR) is a key factor in cardiometabolic diseases, but there are few practical ways to measure it in adolescents. The insulin sensitivity’s surrogate measure, the eGDR, has not been well validated in young populations. Methods eGDR was determined by the use of waist circumference (WC), HbA1c levels, and hypertension status in this cross-sectional study of Chinese adolescents. Restricted cubic spline models and multivariate logistic regression were utilized to estimate associations between eGDR and cardiometabolic risk factors (CMRFs), such as dyslipidemia, hyperuricemia, and high fasting plasma glucose (FPG). The eGDR’s discriminative performance was compared with traditional IR indices, such as HOMA-IR, TyG, AIP, TyG-BMI, and QUIKI. Results After confounders’ adjustment, each SD raise in eGDR was linked with reduced odds of dyslipidemia (OR = 0.781, 95% CI: 0.703–0.866, p < 0.001) and hyperuricemia (OR = 0.884, 95% CI: 0.800–0.977, p = 0.016). eGDR showed negative correlations with atherogenic lipid subfractions, such as LDL-C, non-HDL-C, and triglycerides (TG), but not with total cholesterol (TC) or FPG. Subgroup analyses showed that the protective effect against dyslipidemia was stronger in participants with BMI in the ≥ 85th percentile, and sex-specific differences in the associations with TG and FPG. eGDR was found to be better than traditional IR indices in discriminating clustered CMRFs. Sex-specific cut-offs for IR were determined: eGDR <8.06 mg/kg/min and <8.46 mg/kg/min for males and females, respectively. Conclusion eGDR is a strong, non-invasive cardiometabolic risk indicator in adolescents, especially dyslipidemia and hyperuricemia. It can offer a feasible instrument of early risk stratification in this group.