Correlation between estimated glucose disposal rate, insulin resistance, and cardiovascular mortality among individuals with metabolic syndrome: a population-based analysis, evidence from NHANES 1999–2018

Abstract Background Estimated glucose disposal rate (eGDR), is an index of insulin resistance. It is intimately correlated with inflammation and endothelial dysfunction, both of which are contributory factors in the pathogenesis of cardiovascular disease (CVD) and premature mortality. This study aim...

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Main Authors: Dawei Xing, Jing Xu, Xiaochun Weng, Xiaolu Weng
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Diabetology & Metabolic Syndrome
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Online Access:https://doi.org/10.1186/s13098-024-01574-8
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author Dawei Xing
Jing Xu
Xiaochun Weng
Xiaolu Weng
author_facet Dawei Xing
Jing Xu
Xiaochun Weng
Xiaolu Weng
author_sort Dawei Xing
collection DOAJ
description Abstract Background Estimated glucose disposal rate (eGDR), is an index of insulin resistance. It is intimately correlated with inflammation and endothelial dysfunction, both of which are contributory factors in the pathogenesis of cardiovascular disease (CVD) and premature mortality. This study aims to explore the correlation between eGDR and both all-cause and CVD-related mortality in adults with metabolic syndrome (MetS). Methods A total of 8215 subjects with MetS screened from the National Health and Nutrition Examination Survey (NHANES) during the period from 1999 to 2018 were evaluated for the predictive value of eGDR for CVD and all-cause mortality. Results Over a median follow-up for 8.3 years, a total of 1537 all-cause deaths (18.7%) and 467 CVD-related deaths (5.7%) were recorded. Logistic regression analyses revealed a significant inverse correlation between eGDR and the risk of having CVD (OR:0.845, 95%CI:0.807–0.884, p < 0.01). Multivariate Cox regression analysis and restricted cubic splines analysis demonstrated that eGDR is non-linearly correlated with both the mortality of CVD (HR: 0.906, 95% CI: 0.850–0.967, p = 0.003) and all-cause mortality (HR: 0.944, 95% CI: 0.912–0.977, p = 0.001), with an identified inflection point at 5.918. Further subgroup analyses indicated a more pronounced correlation between eGDR and all-cause mortality in individuals under 60 years old (HR: 0.893, 95%CI:0.823–0.970) or those with obesity (HR:0.891, 95%CI:0.839–0.946). Mediation analysis revealed that neutrophil to lymphocyte ratio mediated 8.9% of the correlation between eGDR and all-cause mortality. Conclusion This study demonstrates, for the first time, that a decrease in eGDR is associated with an increased risk of all-cause and CVD mortality in adults with MetS. The eGDR indices could serve as surrogate biomarkers for monitoring patients with MetS.
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spelling doaj-art-64227dc341c940e1a6c397f2321916132025-01-12T12:33:35ZengBMCDiabetology & Metabolic Syndrome1758-59962025-01-0117111210.1186/s13098-024-01574-8Correlation between estimated glucose disposal rate, insulin resistance, and cardiovascular mortality among individuals with metabolic syndrome: a population-based analysis, evidence from NHANES 1999–2018Dawei Xing0Jing Xu1Xiaochun Weng2Xiaolu Weng3Department of Cardiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityDepartment of Endocrinology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityDepartment of Ultrasound, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityDepartment of Endocrinology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityAbstract Background Estimated glucose disposal rate (eGDR), is an index of insulin resistance. It is intimately correlated with inflammation and endothelial dysfunction, both of which are contributory factors in the pathogenesis of cardiovascular disease (CVD) and premature mortality. This study aims to explore the correlation between eGDR and both all-cause and CVD-related mortality in adults with metabolic syndrome (MetS). Methods A total of 8215 subjects with MetS screened from the National Health and Nutrition Examination Survey (NHANES) during the period from 1999 to 2018 were evaluated for the predictive value of eGDR for CVD and all-cause mortality. Results Over a median follow-up for 8.3 years, a total of 1537 all-cause deaths (18.7%) and 467 CVD-related deaths (5.7%) were recorded. Logistic regression analyses revealed a significant inverse correlation between eGDR and the risk of having CVD (OR:0.845, 95%CI:0.807–0.884, p < 0.01). Multivariate Cox regression analysis and restricted cubic splines analysis demonstrated that eGDR is non-linearly correlated with both the mortality of CVD (HR: 0.906, 95% CI: 0.850–0.967, p = 0.003) and all-cause mortality (HR: 0.944, 95% CI: 0.912–0.977, p = 0.001), with an identified inflection point at 5.918. Further subgroup analyses indicated a more pronounced correlation between eGDR and all-cause mortality in individuals under 60 years old (HR: 0.893, 95%CI:0.823–0.970) or those with obesity (HR:0.891, 95%CI:0.839–0.946). Mediation analysis revealed that neutrophil to lymphocyte ratio mediated 8.9% of the correlation between eGDR and all-cause mortality. Conclusion This study demonstrates, for the first time, that a decrease in eGDR is associated with an increased risk of all-cause and CVD mortality in adults with MetS. The eGDR indices could serve as surrogate biomarkers for monitoring patients with MetS.https://doi.org/10.1186/s13098-024-01574-8eGDRDiabetesMortalityInsulin resistanceCardiovascular disease
spellingShingle Dawei Xing
Jing Xu
Xiaochun Weng
Xiaolu Weng
Correlation between estimated glucose disposal rate, insulin resistance, and cardiovascular mortality among individuals with metabolic syndrome: a population-based analysis, evidence from NHANES 1999–2018
Diabetology & Metabolic Syndrome
eGDR
Diabetes
Mortality
Insulin resistance
Cardiovascular disease
title Correlation between estimated glucose disposal rate, insulin resistance, and cardiovascular mortality among individuals with metabolic syndrome: a population-based analysis, evidence from NHANES 1999–2018
title_full Correlation between estimated glucose disposal rate, insulin resistance, and cardiovascular mortality among individuals with metabolic syndrome: a population-based analysis, evidence from NHANES 1999–2018
title_fullStr Correlation between estimated glucose disposal rate, insulin resistance, and cardiovascular mortality among individuals with metabolic syndrome: a population-based analysis, evidence from NHANES 1999–2018
title_full_unstemmed Correlation between estimated glucose disposal rate, insulin resistance, and cardiovascular mortality among individuals with metabolic syndrome: a population-based analysis, evidence from NHANES 1999–2018
title_short Correlation between estimated glucose disposal rate, insulin resistance, and cardiovascular mortality among individuals with metabolic syndrome: a population-based analysis, evidence from NHANES 1999–2018
title_sort correlation between estimated glucose disposal rate insulin resistance and cardiovascular mortality among individuals with metabolic syndrome a population based analysis evidence from nhanes 1999 2018
topic eGDR
Diabetes
Mortality
Insulin resistance
Cardiovascular disease
url https://doi.org/10.1186/s13098-024-01574-8
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