Joint association of estimated glucose disposal rate and aggregate index of systemic inflammation with mortality in general population: a nationwide prospective cohort study
Authors' conclusion
In a nationally representative U.S. cohort, eGDR and log₂(AISI) were independently and jointly associated with all-cause and CVD mortality. Their combined assessment improves risk stratification and may help identify individuals most likely to benefit from targeted preventive and anti-inflammatory strategies.
Study context
- Population
- Adults from NHANES 1999–2018 linked to the National Death Index
- Participants
- 50,654 adults
- Exposure
- Low estimated glucose disposal rate (eGDR) and high log₂ vs other joint categories
- Outcome
- All-cause and CVD mortality
- Follow-up
- Median 120 months
Methodological detailsnationwide, survey-weighted Cox models, Fine-Gray competing-risk models
- Nationwide
- Survey-weighted Cox models
- Fine-Gray competing-risk models
Main finding
As reported in the abstract
Joint eGDR and log₂(AISI): low eGDR (≤ 8.40) and high log₂(AISI) (> 7.98)
- All-cause mortality, HR
- 1.58 (1.38-1.81) (95% CI)
- CVD mortality, cause-specific HR
- 2.09 (1.58-2.77) (95% CI)
- CVD mortality, Fine-Gray sHR
- 2.13 (1.66-2.74) (95% CI)
- Graded separation of cumulative incidence functions (CIFs), Gray's test
- P < 0.001
Observational data: associations, not effects.
Further findings
eGDR per 1-unit increase
- All-cause mortality HR
- 0.90 (0.88-0.92) (95% CI)
- CVD mortality sHR
- 0.88 (0.85-0.91) (95% CI)
Log₂(aggregate index of systemic inflammation (AISI)) per doubling
- All-cause mortality HR
- 1.10 (1.06-1.15) (95% CI)
- CVD mortality sHR
- 1.13 (1.06-1.20) (95% CI)
Discrimination of combined model (AUC) · 5/10 years
- All-cause AUC 5/10 years
- 0.705/0.723
- CVD AUC 5/10 years
- 0.754/0.769
Deaths · median follow-up 120 months
- All-cause deaths
- 6,936
- CVD deaths
- 2,170
Sensitivity analyses
- Results were consistent across sensitivity analyses
Original publication
Joint association of estimated glucose disposal rate and aggregate index of systemic inflammation with mortality in general population: a nationwide prospective cohort study. Cardiovasc Diabetol. Published 22 January 2026. doi:10.
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