The predictive value of estimated glucose disposal rate for all-cause and cardiovascular mortality in the US non-diabetic population aged ≥60 years: A population-based cohort study

Abstract

Aims

This study seeks to evaluate the prognostic significance of eGDR in predicting mortality outcomes within non-diabetic older adults.

Methods

8131 non-diabetic participants aged ≥60 years from the National Health and Nutrition Examination Survey (2001–2018) was included in this study. eGDR was calculated as: eGDR (mg/kg/min) = 21.158 – [0.09 × waist circumference (cm)] – [3.407 × Hypertension (Yes = 1/No = 0)] – [0.551 × HbA1c (%)]. Weighted Cox proportional hazards models, cumulative hazard curves, restricted cubic spline (RCS), and threshold effects analyses were performed to explore the relationship between eGDR and mortality outcomes. Subgroup analyses and mediation effects analyses were conducted.

Results

2566 all-cause deaths and 689 cardiovascular deaths were recorded. Lower eGDR was associated with higher all-cause (HR = 0.76, 95 % CI: 0.63–0.91) and cardiovascular mortality (HR = 0.56, 95 % CI: 0.40–0.80). Inflection points were identified through RCS curve analyses, and the threshold effect was significant. The eGDR-mortality association remained consistent across subgroups. Mediation analyses showed that neutrophil to high-density lipoprotein cholesterol ratio mediated the association.

Conclusions

Lower eGDR levels are linked to higher risk of both all-cause and cardiovascular mortality in non-diabetic older adults, suggesting its potential utility for risk assessment among this population.