Li Yan, Ye Xi, Chen Xiaoyu
Department of Clinical Pharmacy, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.
Front Med (Lausanne). 2025 Jul 2;12:1589245. doi: 10.3389/fmed.2025.1589245. eCollection 2025.
The incidence of insulin resistance, as determined by estimated glucose disposal rate (eGDR), is associated with various morbidities. The relationship between eGDR and chronic liver diseases remains to be explored. This study examined the association between eGDR and the risk of future metabolic dysfunction-associated steatotic liver disease (MASLD), cirrhosis, liver cancer, and liver-related mortality.
We analyzed data from UK Biobank participants with no history of liver diseases. We calculated the eGDR values for each participant and divided them into four quartile groups based on these values. The primary outcome was MASLD, whereas the secondary outcomes included cirrhosis, liver cancer, and liver-related mortality. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazard regression models. We used restricted cubic splines models to detect potential non-linear relationships.
This study included data from 290,397 UK Biobank participants who had no history of liver diseases, and the magnetic resonance imaging (MRI)-derived liver proton density fat fraction (PDFF) analysis included 25,810 individuals. Over a median follow-up period of 15.69 years, we identified 3,926 cases of MASLD, 1,553 cases of cirrhosis, 167 cases of liver cancer, and 120 cases of liver-related mortality. After adjusting for multiple variables, higher eGDR levels were significantly associated with a lower risk of MASLD (HR: 0.91, 95% CI: 0.90-0.93), cirrhosis (HR: 0.89, 95% CI: 0.86-0.92), and liver cancer (HR: 0.91, 95% CI: 0.83-1.00). Comparing participants between the lowest and highest quartiles (Q1 and Q4) of eGDR, Q4 had a 47% lower risk of MASLD (HR: 0.53; 95% CI: 0.45-0.63), with similar results for cirrhosis. Moreover, high eGDR levels were associated with a low risk of MASLD based on MRI-derived liver PDFF > 5% (odds ratio: 0.98, 95% CI: 0.97-0.98).
We found a significant inverse correlation between eGDR and MASLD, cirrhosis, and liver cancer. Incorporating eGDR into clinical decision-making can improve the long term follow-up of patients with MASLD.
通过估计葡萄糖处置率（eGDR）确定的胰岛素抵抗发生率与多种疾病相关。eGDR与慢性肝病之间的关系仍有待探索。本研究调查了eGDR与未来代谢功能障碍相关脂肪性肝病（MASLD）、肝硬化、肝癌及肝脏相关死亡率风险之间的关联。
我们分析了英国生物银行中无肝脏疾病史参与者的数据。计算了每位参与者的eGDR值，并根据这些值将他们分为四个四分位数组。主要结局是MASLD，次要结局包括肝硬化、肝癌和肝脏相关死亡率。我们使用Cox比例风险回归模型估计风险比（HRs）和95%置信区间（CIs）。我们使用受限立方样条模型来检测潜在的非线性关系。
本研究纳入了290,397名无肝脏疾病史的英国生物银行参与者的数据，磁共振成像（MRI）衍生的肝脏质子密度脂肪分数（PDFF）分析纳入了25,810人。在中位随访期15.69年期间，我们确定了3926例MASLD、1553例肝硬化、167例肝癌和120例肝脏相关死亡病例。在调整多个变量后，较高的eGDR水平与较低的MASLD风险（HR：0.91，95%CI：0.90 - 0.93）、肝硬化风险（HR：0.89，95%CI：0.86 - 0.92）和肝癌风险（HR：0.91，95%CI：0.83 - 1.00）显著相关。比较eGDR最低和最高四分位数（Q1和Q4）的参与者，Q4的MASLD风险降低47%（HR：0.53；95%CI：0.45 - 0.63），肝硬化的结果相似。此外，基于MRI衍生的肝脏PDFF>5%，高eGDR水平与低MASLD风险相关（优势比：0.98，95%CI：0.97 - 0.98）。
我们发现eGDR与MASLD、肝硬化和肝癌之间存在显著的负相关。将eGDR纳入临床决策可以改善MASLD患者的长期随访。
