Gender differences in the association between insulin resistance assessed by estimated glucose disposal rate and the risk of all-cause and cardiovascular deaths in adults without diabetes

Haixu Wang; Zeming Zhou; Xiaoxin Liu; Ying Chen

doi:10.1016/j.diabres.2024.111966

Gender differences in the association between insulin resistance assessed by estimated glucose disposal rate and the risk of all-cause and cardiovascular deaths in adults without diabetes

Diabetes Res Clin Pract. 2024 Dec 19:111966. doi: 10.1016/j.diabres.2024.111966. Online ahead of print.

Authors

Haixu Wang¹, Zeming Zhou², Xiaoxin Liu³, Ying Chen⁴

Affiliations

¹ NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China; National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China.
² National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China.
³ Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: 18515958723@163.com.
⁴ NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China. Electronic address: yingchen1973@126.com.

PMID: 39709110
DOI: 10.1016/j.diabres.2024.111966

Abstract

Aim: We intended to examine the relationship between estimated glucose disposal rate (eGDR) and risks of all-cause and cardiovascular deaths in non-diabetic adults.

Methods: 38,175 participants from the National Health and Nutrition Examination Survey (1999-2018) were included, and deaths were identified through the National Death Index.

Results: With a median follow-up of 9.8 years, we found that dose-response relationships between eGDR level and the risk of death differed between genders. In female participants, higher eGDR level was linearly correlated with lower risks of all-cause and cardiovascular deaths. In contrast, among male participants, there were L-shaped relationships between eGDR and risks of all-cause and cardiovascular deaths, with threshold points of 8.50 and 8.49 mg/kg/min, respectively. To the left of threshold points, eGDR was negatively linked with risks of all-cause (HR 0.91, 95 % CI 0.88-0.94, P < 0.001) and cardiovascular deaths (HR 0.87, 95 % CI 0.82-0.93, P < 0.001). After the inflection point, an increase in eGDR was not related to lower risks of all-cause and cardiovascular deaths (P > 0.05).

Conclusion: Higher eGDR level was associated with lower risks of all-cause and cardiovascular deaths in a linear dose-response manner among non-diabetic females, while L-shaped relationships were observed among non-diabetic males.

Keywords: Death; Gender; Non-diabetic; Risk; eGDR.