Shuwei Shi,1,2 Xia Sun,3 Jie Sheng,1,2 Xuan Ma,1,2 Hongyan Zhao,1,2 Guanqi Gao,2 Baolan Ji2 

1School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, People’s Republic of China; 2Department of Endocrinology, Linyi People’s Hospital Affiliated to Shandong Second Medical University, Linyi, Shandong, People’s Republic of China; 3Internet Hospital Management Office, Linyi People’s Hospital Affiliated to Shandong Second Medical University, Linyi, Shandong, People’s Republic of China

Correspondence: Baolan Ji; Guanqi Gao, Department of Endocrinology, Linyi People’s Hospital Affiliated to Shandong Second Medical University, North Side of the Intersection of Wohushan Road and Wuhan Road in Lanshan District, Linyi, Shandong, 276034, People’s Republic of China, Email jibaolan@yeah.net; guanqi_gao@yeah.net

Aim: Insulin resistance (IR) is closely associated with arterial stiffness (AS) and cardiovascular diseases (CVDs). Recently, several non-insulin-based IR surrogate markers have been demonstrated to be related to AS. The natural log transformation of the glucose disposal rate (loge GDR) is a novel indicator of insulin sensitivity (IS) developed in patients with type 2 diabetes (T2D). We aim to investigate the relationship between the loge GDR and AS in non-obese patients with T2D.
Methods: A cross-sectional study of 790 non-obese patients with T2D were included. Clinical and biochemical characteristics were collected. AS was assessed by brachial-ankle pulse wave velocity (baPWV), and according to the baPWV levels, patients were divided into two groups: AS group (baPWV ≥ 1800 cm/s) and non-AS group (baPWV < 1800 cm/s). The correlation between AS and loge GDR was analyzed.
Results: Compared with the non-AS group, the loge GDR decreased in the AS group (P < 0.001). With the tertiles of loge GDR increased, the bapWV and the prevalence of AS were decreased (both P < 0.001). Univariate analysis showed that the loge GDR was negatively correlated with the baPWV and AS (both P < 0.001). Furthermore, multivariate regression analyses demonstrated that the loge GDR was independently associated with bapWV (β: − 0.162; P < 0.001) and AS (OR: 0.286; 95% CI: 0.110– 0.743). Integrating loge GDR modestly improved the ability of the model to identify AS (Net reclassification improvement (NRI): 0.043, 95% CI 0.009– 0.079, P = 0.011).
Conclusion: The loge GDR is independently correlated with AS in non-obese patients with T2D, and its utility for risk stratification requires further validation.

Keywords: type 2 diabetes, baPWV, insulin resistance, Loge GDR