Synergistic association of estimated glucose disposal rate and neutrophil-to-albumin ratio with accelerated biological aging
Authors' conclusion
Reduced insulin sensitivity and heightened inflammation-nutrition imbalance are independently and synergistically associated with accelerated biological aging. The interplay between eGDR and NPAR, particularly their joint effect, highlights the pivotal role of the metabolic-inflammatory axis in the aging process. These findings suggest that combined monitoring of eGDR and NPAR could be a valuable strategy for early risk stratification and the development of personalized anti-aging interventions.
Study context
- Population
- U.S. adults aged ≥20 years in National Health and Nutrition Examination Survey (NHANES) 1999–2010 and 2015–2018
- Participants
- 35,169 adults
- Exposure
- Estimated glucose disposal rate (eGDR) and neutrophil-to-albumin ratio (NPAR) vs biological age acceleration
- Outcome
- Biological age acceleration (biological age (BA) exceeding chronological age) by KDM-BA and PhenoAge
Methodological detailsNHANES 1999-2010 and 2015-2018, multivariable regression, restricted cubic spline models
- NHANES 1999-2010 and 2015-2018
- Multivariable regression
- Restricted cubic spline models
Main finding
As reported in the abstract
Biological age acceleration (fully adjusted)
- eGDR per 1-unit increase, Klemera-Doubal method biological age (KDM-BA) acceleration: OR
- 0.69 (95% CI 0.67-0.72)
- Highest vs lowest eGDR tertile, KDM-BA acceleration: OR (95% CI 0.14-0.20); 83% lower odds
- 0.17
- NPAR per unit increase, KDM-BA acceleration: OR
- 1.12 (95% CI 1.10-1.14)
- NPAR per unit increase, PhenoAge acceleration: OR
- 1.27 (95% CI 1.24-1.30)
- Highest vs lowest NPAR tertile, KDM-BA acceleration: OR
- 1.90 (95% CI 1.53-2.36)
- Highest vs lowest NPAR tertile, PhenoAge acceleration: OR
- 3.39 (95% CI 2.91-3.95)
- Low eGDR + high NPAR, KDM-BA acceleration: OR
- 5.46 (95% CI 4.60-6.48)
- Low eGDR + high NPAR, PhenoAge acceleration: OR
- 2.98 (95% CI 2.46-3.62)
Observational data: associations, not effects.
Further findings
Dose-response
- Both biomarkers showed significant nonlinear dose-response relationships with aging outcomes
Subgroups
- Significant heterogeneity; associations varied by BMI and CKD status
Original publication
Synergistic association of estimated glucose disposal rate and neutrophil-to-albumin ratio with accelerated biological aging. Diabetes Res Clin Pract. Published 31 August 2025. doi:10.
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