Qian Han, Chai Dayang, Zhao Shouming
Department of Cardiology, The First People's Hospital of Taicang, Taicang Affiliated Hospital of Soochow University, Taicang, Jiangsu, China.
Front Endocrinol (Lausanne). 2025 Jul 30;16:1583991. doi: 10.3389/fendo.2025.1583991. eCollection 2025.
The estimated glucose disposal rate (eGDR) is a noninvasive and practical marker for assessing insulin resistance, but its association with mortality in postmenopausal women remains uncertain.
A cohort of 9371 postmenopausal women from the National Health and Nutrition Examination Survey (1999-2018) was studied. Baseline eGDR was calculated, and mortality outcomes (all-cause and cardiovascular) were linked to National Death Index (NDI) records up to December 31, 2019. Multivariate Cox regression, restricted cubic splines, and subgroup analyses were employed to assess the relationships between eGDR and mortality.
During a median follow-up of 98 months, 2151 deaths from all causes and 679 from cardiovascular causes were documented. In the multivariable-adjusted Cox model, higher eGDR quartiles were associated with progressively lower all-cause and cardiovascular mortality. In comparison to the lowest eGDR quartile, the highest quartile showed adjusted hazard ratios of 0.765 (0.646-0.906) for all-cause mortality and 0.677 (0.498-0.921) for cardiovascular mortality. A U-shaped relationship between eGDR and all-cause mortality was identified, with an inflection point at 5.11 mg/kg/min. Subgroup analyses revealed a stronger association between eGDR and all-cause as well as cardiovascular mortality in individuals younger than 60 years.
Among postmenopausal women, decreased eGDR, signifying higher insulin resistance, correlates with greater risks of all-cause and cardiovascular mortality.
估计葡萄糖处置率（eGDR）是评估胰岛素抵抗的一种非侵入性实用指标，但其与绝经后女性死亡率的关联仍不确定。
对来自美国国家健康与营养检查调查（1999 - 2018年）的9371名绝经后女性队列进行了研究。计算基线eGDR，并将死亡结局（全因和心血管原因）与截至2019年12月31日的国家死亡指数（NDI）记录相关联。采用多变量Cox回归、受限立方样条和亚组分析来评估eGDR与死亡率之间的关系。
在中位随访98个月期间，记录了2151例全因死亡和679例心血管原因死亡。在多变量调整的Cox模型中，较高的eGDR四分位数与全因和心血管死亡率逐渐降低相关。与最低的eGDR四分位数相比，最高四分位数的全因死亡率调整后风险比为0.765（0.646 - 0.906），心血管死亡率为0.677（0.498 - 0.921）。确定了eGDR与全因死亡率之间呈U形关系，拐点为5.11 mg/kg/min。亚组分析显示，在60岁以下个体中，eGDR与全因以及心血管死亡率之间的关联更强。
在绝经后女性中，eGDR降低表明胰岛素抵抗增加，与全因和心血管死亡率风险增加相关。
