Association of estimated glucose disposition rate with aging acceleration and mortality risk in individuals with cardiovascular-kidney-metabolic syndrome: evidence from two large national population-based studies
Authors' conclusion
In the CKM population, lower eGDR levels may be associated with both AgeAccel and an increased risk of mortality, with AgeAccel potentially mediating the relationship between eGDR and mortality. These findings suggested that eGDR could serve as a potential predictor and intervention target for delaying aging and reducing mortality risk.
Study context
- Population
- Adults with cardiovascular-kidney-metabolic (CKM) syndrome stages 1 to 4, National Health and Nutrition Examination Survey (NHANES) 2005–2010; replication in China Health and Retirement Longitudinal Study (CHARLS)NHANES
- Participants
- 4,826 adults
- Exposure
- Per-unit increase in estimated glucose disposal rate (eGDR)
- Outcome
- All-cause and CVD mortality
Methodological detailssurvey-weighted, replication in CHARLS cohort, causal mediation analysis, machine learning prognostic models
- Survey-weighted
- Replication in CHARLS cohort
- Causal mediation analysis
- Machine learning prognostic models
Main finding
As reported in the abstract
All-cause mortality events
831
Cardiovascular disease (CVD) deaths
208
All-cause mortality, HR per unit eGDR
0.90
95% CI 0.86–0.93
CVD mortality, HR per unit eGDR
0.87
95% CI 0.81–0.93
Observational data: associations, not effects.
Further findings
AgeAccel per unit eGDR
- BioAgeAccel, OR
- 0.85 (95% CI 0.82-0.87)
- PhenoAgeAccel, OR
- 0.78 (95% CI 0.75-0.80)
Prediction of all-cause mortality from eGDR
- K-Nearest Neighbors (KNN) AUC, superior to other machine learning algorithms
- 0.926
Mediation by PhenoAgeAccel
- Proportion mediated, all-cause mortality
- 23.53%
- Proportion mediated, CVD mortality
- 15.73%
Original publication
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