Estimated glucose disposal rate as a candidate biomarker for thrombotic biomarkers in T1D: a pooled analysis

Purpose To determine the utility of estimated glucose disposal rate (eGDR) as a candidate biomarker for thrombotic biomarkers in patients with type 1 diabetes (T1D). Methods We reanalysed baseline pretreatment data in a subset of patients with T1D from two previous RCTs, consisting of a panel of thrombotic markers, including fibrinogen, tissue factor (TF) activity, and plasminogen-activator inhibitor (PAI)-1, and TNF alpha, and clinical factors (age, T1D duration, HbA1c, insulin requirements, BMI, blood pressure, and eGDR). We employed univariate linear regression models to investigate associations between clinical parameters and eGDR with thrombotic biomarkers. Results Thirty-two patients were included [mean +/- SD age 31 +/- 7 years, HbA1c of 58 +/- 9 mmol/mol (7.5 +/- 0.8%), eGDR 7.73 +/- 2.61]. eGDR negatively associated with fibrinogen (P < 0.001), PAI-1 concentrations (P = 0.005), and TF activity (P = 0.020), but not TNF alpha levels (P = 0.881). We identified 2 clusters of patients displaying significantly different characteristics; 56% (n = 18) were categorised as 'higher-risk', eliciting significantly higher fibrinogen (+ 1514 +/- 594 mu g/mL; P < 0.001), TF activity (+ 59.23 +/- 9.42 pmol/mL; P < 0.001), and PAI-1 (+ 8.48 +/- 1.58 pmol/dL; P < 0.001), HbA1c concentrations (+ 14.20 +/- 1.04 mmol/mol; P < 0.001), age (+ 7 +/- 3 years; P < 0.001), duration of diabetes (15 +/- 2 years; P < 0.001), BMI (+ 7.66 +/- 2.61 kg/m(2); P < 0.001), and lower mean eGDR (- 3.98 +/- 1.07; P < 0.001). Conclusions Compared to BMI and insulin requirements, classical surrogates of insulin resistance, eGDR is a suitable and superior thrombotic risk indicator in T1D.

Automated summary

The study found that eGDR was negatively associated with thrombotic biomarkers and could serve as a better indicator for thrombotic risk in diabetic patients, aiding in identifying high-risk groups.