Zhu Botao, Cao Chenghui, Liu Wenwu, Liu Yuxuan, Luo Yonghong, Peng Daoquan
Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Diabetes Metab Syndr. 2025 Jan;19(1):103182. doi: 10.1016/j.dsx.2024.103182. Epub 2024 Dec 20.
This study seeks to evaluate the prognostic significance of eGDR in predicting mortality outcomes within non-diabetic older adults.
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.
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.
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.
本研究旨在评估估算肾小球滤过率（eGDR）在预测非糖尿病老年人群死亡结局方面的预后意义。
本研究纳入了来自美国国家健康与营养检查调查（2001 - 2018年）的8131名年龄≥60岁的非糖尿病参与者。eGDR的计算方法为：eGDR（毫克/千克/分钟）= 21.158 - [0.09×腰围（厘米）] - [3.407×高血压（是 = 1/否 = 0）] - [0.551×糖化血红蛋白（%）]。采用加权Cox比例风险模型、累积风险曲线、受限立方样条（RCS）和阈值效应分析来探讨eGDR与死亡结局之间的关系。进行了亚组分析和中介效应分析。
记录到2566例全因死亡和689例心血管死亡。较低的eGDR与较高的全因死亡率（风险比[HR] = 0.76，95%置信区间[CI]：0.63 - 0.91）和心血管死亡率（HR = 0.56，95% CI：0.40 - 0.80）相关。通过RCS曲线分析确定了拐点，且阈值效应显著。eGDR与死亡率的关联在各亚组中保持一致。中介分析表明，中性粒细胞与高密度脂蛋白胆固醇比值介导了这种关联。
较低的eGDR水平与非糖尿病老年人群全因死亡和心血管死亡的较高风险相关，表明其在该人群风险评估中的潜在效用。
