Association of the estimated glucose disposal rate with and mortality risk in patients with atherosclerotic cardiovascular disease: A cohort study from the NHANES 1999–2018
Authors' conclusion
Lower eGDR was associated with increased mortality risk in ASCVD, particularly among patients without diabetes. eGDR enhances mortality prediction and may serve as a prognostic marker in ASCVD.
Study context
- Population
- Patients with atherosclerotic cardiovascular disease (ASCVD), NHANES 1999–2018; 67.40 % ≥60 years, 44.66 % female
- Participants
- 4,425 patients
- Exposure
- Lowest vs highest estimated glucose disposal rate (eGDR) quartile
- Outcome
- CVD and all-cause mortality
- Follow-up
- Median 6.9 years
Methodological detailsNHANES 1999–2018, weighted Cox regression, restricted cubic splines
- NHANES 1999–2018
- Weighted Cox regression
- Restricted cubic splines
Main finding
As reported in the abstract
Hazard ratio
2.13
CVD mortality
Hazard ratio
2.06
all-cause mortality
- Deaths
- 1,815 (35.62 %)
- CVD deaths
- 751 (18.48 %)
- RCS demonstrated linearity
- P-nonlinear > 0.05
Observational data: associations, not effects.
Further findings
Predictive performance
- Addition of eGDR improved prediction of CVD and all-cause mortality; other insulin resistance indicators did not yield comparable improvements
- P < 0.001
Effect modification by diabetes status, CVD mortality
- Diabetes status modified the association with CVD mortality
- P for interaction = 0.029
Mediation
- Neutrophil-to-lymphocyte ratio and estimated pulse wave velocity were key mediators
Original publication
Association of the estimated glucose disposal rate with and mortality risk in patients with atherosclerotic cardiovascular disease: A cohort study from the NHANES 1999–2018. Diabetes Res Clin Pract. Published 21 May 2025. doi:10.
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