{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:09:38Z","timestamp":1791806978671,"version":"4.3.4"},"reference-count":34,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100016966","name":"Bethune Charitable Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016966","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Lower extremity arterial disease (LEAD), a prevalent but under\u2010recognised macrovascular complication of type 2 diabetes mellitus (T2DM), is closely linked to insulin resistance (IR). The estimated glucose disposal rate (eGDR), a surrogate marker of IR, may facilitate early LEAD risk stratification; however, its clinical utility remains underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional analysis of 7482 adults aged \u226550\u2009years with T2DM, from the China DIA\u2010LEAD study evaluated the association between eGDR (quartiles: Q1\u2010Q4) and LEAD, defined by the ankle\u2013brachial index (ABI\u2009&lt;0.9 or &gt;1.3). Multivariate logistic regression and restricted cubic spline (RCS) models were used to assess the nonlinear relationships, adjusted for demographics, metabolic factors and comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants in the lower eGDR quartiles showed a progressively higher LEAD prevalence (Q1: 31.4% vs. Q4: 12.8%), worse glycaemic control (HbA1c Q1: 9.8% vs. Q4: 7.3%) and a greater comorbidity burden (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In fully adjusted models, Q1 had a 2.23\u2010fold higher LEAD risk versus Q4 (95% CI 1.47\u20133.37). Each 1\u2010unit eGDR increase conferred a 24% lower LEAD risk (adjusted OR 0.76, 95% CI 0.70\u20130.84). RCS analysis revealed an L\u2010shaped relationship, with sharp risk escalation at eGDR &lt;\u20098\u2009mg\/kg\/min (\n                      <jats:italic>p<\/jats:italic>\n                      for nonlinearity\u2009=\u20090.003). Subgroup analyses confirmed consistency across populations (all\n                      <jats:italic>p<\/jats:italic>\n                      for interaction &gt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>eGDR demonstrated a significant inverse L\u2010shaped association with LEAD in patients with T2DM. These findings support the clinical utility of eGDR as a practical indicator of LEAD risk screening and management. Patients with lower eGDR may benefit from insulin\u2010sensitising therapies, which could reduce both glucose levels and the risk of LEAD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.16514","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T05:14:13Z","timestamp":1749446053000},"page":"4763-4771","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Association between estimated glucose disposal rate and lower extremity arterial disease in type 2 diabetes: A nationwide cross\u2010sectional study from China"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3099-2621","authenticated-orcid":false,"given":"Xiaowei","family":"Wei","sequence":"first","affiliation":[{"name":"Department of Endocrinology The Ninth Medical Center, Chinese PLA General Hospital  Beijing 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