Lipids & metabolic liver disease
Joint association of estimated glucose disposal rate and systemic inflammation response index with mortality in metabolic-dysfunction associated steatotic liver disease: evidence from two cohort studies
Authors' conclusion
Integrating eGDR and SIRI identifies a high-risk MASLD phenotype with the poorest prognosis, reflecting a synergistic metabolic-inflammatory burden. This joint assessment significantly improves predictive accuracy and offers superior net clinical benefits for long-term mortality prediction.
Study context
- Population
- MASLD adults from continuous National Health and Nutrition Examination Survey (NHANES) (1999–2018); external validation cohort of ultrasound-confirmed patients from NHANES III (1988–1994); mortality linked through 20191,182 validation cohort
- Participants
- 7,520 adults
- Exposure
- Low estimated Glucose Disposal Rate (eGDR)/high Systemic Inflammation Response Index (SIRI) phenotype vs other eGDR/SIRI categories
- Outcome
- All-cause and cardiovascular mortality
- Follow-up
- Median 138 months
Methodological detailsobservational, external validation cohort
- Observational
- External validation cohort
Main finding
As reported in the abstract
All-cause deaths
1375
Cardiovascular deaths
442
Low eGDR/high SIRI: risk of all-cause mortality
1.860-fold
95% CI 1.439–2.405
Low eGDR/high SIRI: risk of cardiovascular mortality
2.395-fold
95% CI 1.379–4.159
Observational data: associations, not effects.
Further findings
Predictive performance of combined model
- AUC
- 0.686-0.848
- Net Reclassification Improvement (NRI)
- 0.161
- Integrated Discrimination Improvement (IDI)
- 0.017
- Higher clinical net benefit than either indicator alone
- P < 0.001
Mediation: SIRI share of eGDR–all-cause mortality association
- Proportion mediated by SIRI
- 10.31%
- Exploratory
External validation (NHANES III), low eGDR/high SIRI phenotype
- All-cause mortality HR (p < 0.001)
- 2.354
- Cardiovascular mortality HR (p < 0.001)
- 3.153
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →