Estimated glucose disposal rate (eGDR) in rural Bangladeshi population and its correlation with cardiometabolic risks

Abstract

Background and objectives: For decades type 2 diabetes mellitus (T2DM) and insulin resistance (IR) are increasingly gaining importance as an underlying mechanism for increased risk of cardiovascular diseases (CVD). IR is related to various cardiometabolic adverse effects. Hyperinsulinemic-euglycemic clamp technique, the gold standard method for measuring IR, is an invasive and complex procedure. Estimation of glucose disposal rate (eGDR) is an easy alternative tool for measuring IR. There is no known study on eGDR level in Bangladeshi native population. Therefore, this study was undertaken to determine the eGDR values in a healthy working rural Bangladeshi population. Materials and methods: Six villages were selected purposively as the study sites. All healthy working people aged ≥20 years in selected rural community were considered eligible. Those who consented to participate in the study were enrolled. Investigations included a) interviewing for social and clinical history, b) anthropometry and measurement of blood pressure and d) estimation of HbA1c and biochemical indices. The eGDR (mg/kg/min) was calculated using formula: eGDR = 21.158 − (0.09 * WC) − (3.407 * HT) − (0.551 * HbA1c); where WC = waist circumference in cm, HT = hypertension (yes = 1/no = 0), and HbA1c = HbA1c (%). Results: A total of 93 (m/w = 29/64) participants were enrolled in the study. The prevalence rates of hypertension, diabetes and metabolic syndrome (MSyn) were 34%, 31.1% and 16.1%, respectively. The mean eGDR value was 9.9 (±0.149; 95% CI: 9.62–10.2) mg/kg/min. Most of the values of biophysical characteristics were normal. The comparison between participants with and without MSyn showed that the former had significantly lower eGDR (9.05±1.24 vs.10.10±1.37, p<0.01). Inverse correlations of eGDR with the obesity, glycemia and lipidemia (weight, waist, FBG, T-chol, and TG) were significant. Declining eGDR were significant with rising WHR, WHtR, TG/HDLR and T-chol/HDLR (for all, p<0.05). Conclusions: The study revealed the level of eGDR in a healthy working people of a rural community of Bangladesh. Moreover, eGDR was found to decrease significantly with the increasing cardiometabolic risks. The study revealed a higher prevalence of hypertension, diabetes and metabolic syndrome in apparently healthy working people highlighting susceptibility of Bangladeshi natives to non-communicable diseases. IMC J Med Sci. 2023; 17(2):005. DOI: https://doi.org/10.55010/imcjms.17.015 *Correspondence: M Abu Sayeed, Department of Community Medicine, Ibrahim Medical College, 1/A, Ibrahim Sarani, Segunbagicha, Dhaka 1000, Bangladesh. Email: sayeed1950@gmail.com