Association between eGDR and accelerated aging: the mediating role of ePWV

Abstract

Objective: This study examines the association between estimated glucose disposal rate (eGDR) and accelerated aging in middle-aged and older adults, with a focus on the mediating role of estimated pulse wave velocity (ePWV). Methods: Data from the 2011 wave of the China Health and Retirement Longitudinal Study (CHARLS) were analyzed, including middle-aged and older participants. Biological age was estimated using the Klemera-Doubal method, and accelerated aging was defined as the difference between biological and chronological age. The eGDR was calculated based on waist circumference, hypertension status, and HbA1c levels, while ePWV was estimated using mean blood pressure and age. Logistic regression models assessed the relationship between baseline eGDR, ePWV, and accelerated aging, adjusting for confounders. Results: A total of 8,529 participants (mean age 59.31 years) were included. A significant inverse association was found between eGDR and accelerated aging. Participants with the lowest eGDR quartile had an 81% higher risk of accelerated aging compared to those in the highest quartile (OR = 0.19, 95% CI 0.17–0.22, P < 0.001). Mediation analysis showed that ePWV mediated 12.90% of the relationship between eGDR and accelerated aging (95% CI 9.20%–16.60%). Conclusion: Reduced insulin sensitivity, indicated by low eGDR, is a significant risk factor for accelerated aging. Vascular aging, measured by ePWV, mediates part of this relationship. These findings highlight the importance of monitoring insulin sensitivity and vascular health to mitigate aging and age-related health risks.