Abstract Number: Esoc2026ys120 Association of Estimated Glucose Disposal Rate With Stroke Mortality in a Nationwide Cohort

Abstract Background and aims Insulin resistance (IR) is recognized as a contributor to cardiovascular disease (CVD) and mortality. However, comprehensive understanding on the association between estimated glucose disposal rate (eGDR), a surrogate indicator of IR, and stroke mortality among the general population is lacking. Methods The study included 378,225 participants aged 35-75 years from the China Health Evaluation And risk Reduction through nationwide Teamwork (ChinaHEART) project from May 2015 to August 2019. The individuals were categorized into four subgroups according to the quartiles of eGDR. The study outcomes included ischemic stroke (IS) and hemorrhagic stroke (HS). Cox proportional hazard models and Fine–Gray sub-distribution hazard models were applied to assess the associations between eGDR and stroke mortality. Results During the median 7.5-year follow-up, 2,448 (0.6%) individuals died from stroke mortality (including 945 from IS, and 1,503 from HS). In multivariable-adjusted analyses, the corresponding hazard ratio (95% confidence intervals) for the highest eGDR versus lowest quartile of eGDR was 0.30 (0.25–0.36) for stroke mortality (including 0.33 0.25–0.44 for IS, and 0.28 0.23–0.36 for HS). The results remain consistent in the Fine & Gray models, after considering competing risks and confounding effects. A higher eGDR was found to be significantly associated with a reduced risk of stroke mortality within the general population, including from IS and HS, suggesting that eGDR may serve as a promising predictor and therapeutic target for reducing stroke mortality risks among general population in clinical practice. Conflict of interest Guoliang Hu. nothing to disclose. Shujuan Li. nothing to disclose.