Analyzing the impact of glycemic metabolic status on cardiovascular mortality and all-cause mortality related to the estimated glucose disposal rate: a nationwide cohort study
ObjectiveThe Estimated Glucose Disposal Rate (eGDR) serves as a surrogate marker for insulin resistance, with numerous studies highlighting its significant prognostic value. This paper aims to analyze the impact of eGDR on cardiovascular and all-cause mortality across different glycemic metabolic st...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2024.1494820/full |
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| author | Shiming He Shiming He Shiming He Chao Wang Chao Wang Chao Wang Xin Huang Xin Huang Xin Huang Guoan Jian Guoan Jian Guoan Jian Zihao Lu Zihao Lu Zihao Lu Kun Jiang Kun Jiang Kun Jiang Guobo Xie Guotai Sheng Yang Zou |
| author_facet | Shiming He Shiming He Shiming He Chao Wang Chao Wang Chao Wang Xin Huang Xin Huang Xin Huang Guoan Jian Guoan Jian Guoan Jian Zihao Lu Zihao Lu Zihao Lu Kun Jiang Kun Jiang Kun Jiang Guobo Xie Guotai Sheng Yang Zou |
| author_sort | Shiming He |
| collection | DOAJ |
| description | ObjectiveThe Estimated Glucose Disposal Rate (eGDR) serves as a surrogate marker for insulin resistance, with numerous studies highlighting its significant prognostic value. This paper aims to analyze the impact of eGDR on cardiovascular and all-cause mortality across different glycemic metabolic statuses, including normal fasting glucose (NFG), prediabetes, and diabetes.MethodsThis study included 46,016 American adults who underwent health examinations as part of the National Health and Nutrition Examination Survey from 1999 to 2018. Multivariable Cox regression was employed to explore the relationships between eGDR and mortality rates under varying glycemic states. Additionally, Kaplan-Meier curves were used to compare the cumulative incidence of cardiovascular and all-cause mortality across different metabolic statuses. Finally, the predictive value of eGDR for mortality was assessed using receiver operating characteristic curves.ResultsDuring an average follow-up of 115 months, a total of 6,906 (15.01%) participants experienced all-cause mortality, with 1,798 (3.91%) deaths attributed to cardiovascular causes. Kaplan-Meier analysis revealed that higher eGDR levels were associated with gradually reduced mortality rates. After adjusting for confounders, elevated eGDR levels were protective against both cardiovascular and all-cause mortality; the protective effect was notably stronger for cardiovascular mortality [Cardiovascular mortality hazard ratio: 0.92; All-cause mortality hazard ratio: 0.94]. Further interaction tests indicated that glycemic status significantly modified the protective effect of eGDR (P-interaction<0.0001); specifically, high eGDR conferred stronger protection against cardiovascular and all-cause mortality in individuals with NFG and prediabetes compared to those with diabetes. Receiver operating characteristic analysis suggested that eGDR had superior predictive value for mortality in the NFG and prediabetic populations compared to the diabetic group.ConclusioneGDR is a straightforward surrogate for insulin resistance, acting as a protective factor against cardiovascular and all-cause mortality in American adults, with glycemic status modifying this protective effect. Specifically, high eGDR levels offer stronger protection in individuals with NFG and prediabetes compared to those with diabetes; moreover, eGDR appears to be more suitable for predicting mortality events in the NFG and prediabetic populations. |
| format | Article |
| id | doaj-art-1a0f3377a44a4d55a4e55a948fff8687 |
| institution | Kabale University |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Endocrinology |
| spelling | doaj-art-1a0f3377a44a4d55a4e55a948fff86872025-01-21T05:43:36ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-01-011510.3389/fendo.2024.14948201494820Analyzing the impact of glycemic metabolic status on cardiovascular mortality and all-cause mortality related to the estimated glucose disposal rate: a nationwide cohort studyShiming He0Shiming He1Shiming He2Chao Wang3Chao Wang4Chao Wang5Xin Huang6Xin Huang7Xin Huang8Guoan Jian9Guoan Jian10Guoan Jian11Zihao Lu12Zihao Lu13Zihao Lu14Kun Jiang15Kun Jiang16Kun Jiang17Guobo Xie18Guotai Sheng19Yang Zou20Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaJiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, ChinaJiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, ChinaJiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaJiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, ChinaJiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, ChinaJiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaJiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, ChinaJiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, ChinaJiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaJiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, ChinaJiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, ChinaJiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaJiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, ChinaJiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, ChinaJiangxi Medical College, Nanchang University, Nanchang, Jiangxi, ChinaJiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, ChinaJiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, ChinaJiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, ChinaJiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, ChinaJiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, ChinaObjectiveThe Estimated Glucose Disposal Rate (eGDR) serves as a surrogate marker for insulin resistance, with numerous studies highlighting its significant prognostic value. This paper aims to analyze the impact of eGDR on cardiovascular and all-cause mortality across different glycemic metabolic statuses, including normal fasting glucose (NFG), prediabetes, and diabetes.MethodsThis study included 46,016 American adults who underwent health examinations as part of the National Health and Nutrition Examination Survey from 1999 to 2018. Multivariable Cox regression was employed to explore the relationships between eGDR and mortality rates under varying glycemic states. Additionally, Kaplan-Meier curves were used to compare the cumulative incidence of cardiovascular and all-cause mortality across different metabolic statuses. Finally, the predictive value of eGDR for mortality was assessed using receiver operating characteristic curves.ResultsDuring an average follow-up of 115 months, a total of 6,906 (15.01%) participants experienced all-cause mortality, with 1,798 (3.91%) deaths attributed to cardiovascular causes. Kaplan-Meier analysis revealed that higher eGDR levels were associated with gradually reduced mortality rates. After adjusting for confounders, elevated eGDR levels were protective against both cardiovascular and all-cause mortality; the protective effect was notably stronger for cardiovascular mortality [Cardiovascular mortality hazard ratio: 0.92; All-cause mortality hazard ratio: 0.94]. Further interaction tests indicated that glycemic status significantly modified the protective effect of eGDR (P-interaction<0.0001); specifically, high eGDR conferred stronger protection against cardiovascular and all-cause mortality in individuals with NFG and prediabetes compared to those with diabetes. Receiver operating characteristic analysis suggested that eGDR had superior predictive value for mortality in the NFG and prediabetic populations compared to the diabetic group.ConclusioneGDR is a straightforward surrogate for insulin resistance, acting as a protective factor against cardiovascular and all-cause mortality in American adults, with glycemic status modifying this protective effect. Specifically, high eGDR levels offer stronger protection in individuals with NFG and prediabetes compared to those with diabetes; moreover, eGDR appears to be more suitable for predicting mortality events in the NFG and prediabetic populations.https://www.frontiersin.org/articles/10.3389/fendo.2024.1494820/fullinsulin resistanceestimated glucose disposal ratecardiovascular mortalityeGDRall-cause mortality |
| spellingShingle | Shiming He Shiming He Shiming He Chao Wang Chao Wang Chao Wang Xin Huang Xin Huang Xin Huang Guoan Jian Guoan Jian Guoan Jian Zihao Lu Zihao Lu Zihao Lu Kun Jiang Kun Jiang Kun Jiang Guobo Xie Guotai Sheng Yang Zou Analyzing the impact of glycemic metabolic status on cardiovascular mortality and all-cause mortality related to the estimated glucose disposal rate: a nationwide cohort study Frontiers in Endocrinology insulin resistance estimated glucose disposal rate cardiovascular mortality eGDR all-cause mortality |
| title | Analyzing the impact of glycemic metabolic status on cardiovascular mortality and all-cause mortality related to the estimated glucose disposal rate: a nationwide cohort study |
| title_full | Analyzing the impact of glycemic metabolic status on cardiovascular mortality and all-cause mortality related to the estimated glucose disposal rate: a nationwide cohort study |
| title_fullStr | Analyzing the impact of glycemic metabolic status on cardiovascular mortality and all-cause mortality related to the estimated glucose disposal rate: a nationwide cohort study |
| title_full_unstemmed | Analyzing the impact of glycemic metabolic status on cardiovascular mortality and all-cause mortality related to the estimated glucose disposal rate: a nationwide cohort study |
| title_short | Analyzing the impact of glycemic metabolic status on cardiovascular mortality and all-cause mortality related to the estimated glucose disposal rate: a nationwide cohort study |
| title_sort | analyzing the impact of glycemic metabolic status on cardiovascular mortality and all cause mortality related to the estimated glucose disposal rate a nationwide cohort study |
| topic | insulin resistance estimated glucose disposal rate cardiovascular mortality eGDR all-cause mortality |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2024.1494820/full |
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