{
  "abstract": "Background\n\nEstimated glucose disposal rate (eGDR), a validated surrogate for insulin resistance, is associated with cardiovascular disease, but its relationship with chest pain, which is a common presenting symptom of cardiovascular events, remains unclear. This study investigated the associations of eGDR with chest pain prevalence and all-cause mortality.Methods\n\nUsing cross-sectional and cohort study designs, we analyzed data from 1999 to 2018 National Health and Nutrition Examination Survey (NHANES). Survey-weighted logistic regression was used to examine the association between eGDR and chest pain prevalence, while weighted Cox model was used to evaluate the relationship between eGDR and all-cause mortality in participants with and without chest pain. Restricted cubic splines (RCS) examined potential nonlinearity, and Kaplan-Meier curves visualized survival differences by eGDR category. Mediation analysis examined whether white blood cells (WBC) count mediated the eGDR-mortality association.Results\n\nThe study included 13,161 participants, with the sample being weighted to reflect a population of 54,616,985 individuals. After full adjustment, each standard deviation (SD) increase in eGDR correlated with an 11% lower odds of chest pain (P < 0.001). Cox regression revealed each SD rise in eGDR was associated with a 7% lower risk of all-cause mortality among participants with chest pain (P = 0.004). RCS confirmed linear relationships for eGDR with both chest pain prevalence and mortality risk, irrespective of chest pain status. When eGDR was dichotomized at the population median (7.34 mg/kg/min), participants with high eGDR was significantly associated with reduced odds of chest pain (OR = 0.67, 95% CI: 0.59-0.77, P < 0.001) and lower all-cause mortality (HR = 0.85, 95% CI: 0.75-0.95, P = 0.006) compared to those with low eGDR. Kaplan-Meier curves demonstrated a clear survival advantage for participants with higher eGDR. WBC mediated 20.04% of the association between eGDR and all-cause mortality (Pindirect < 0.001).Conclusion\n\nHigher eGDR is robustly associated with lower chest pain prevalence and reduced all-cause mortality risk, irrespective of chest pain status. The partial mediation by WBC suggests a potential inflammatory pathway. These findings support the potential value of eGDR in non-invasive cardiometabolic risk stratification.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Hand and Plastic Surgery, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China.",
    "Clinical Laboratory Center, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, NO.1111, East Section of Wenzhou Avenue, Longwan District, Wenzhou City, Zhejiang Province, 325000, China. aikoye1207@wmu.edu.cn."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Jieke Wang"
    },
    {
      "affs": [
        1
      ],
      "name": "Manli Ye"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/b07bc7sd017hx.bib",
  "cited_by": 0,
  "doi": "10.1186/s12872-026-06336-0",
  "fulltext_url": "https://europepmc.org/articles/PMC13685353",
  "id": "b07bc7sd017hx",
  "issns": [
    "1471-2261"
  ],
  "landing_url": "https://europepmc.org/article/MED/42902173",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC666-701"
    ],
    [
      "openalex",
      "2712|Diabetes, Cardiovascular Risks, and Lipoproteins"
    ]
  ],
  "openalex": "W7171069748",
  "pdf_url": "https://europepmc.org/articles/PMC13685353?pdf=render",
  "pmcid": "PMC13685353",
  "pmid": "42902173",
  "published": "2026-07-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/b07bc7sd017hx.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:41Z",
      "native_id": "MED:42902173",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42902173"
    },
    {
      "first_seen": "2026-10-30T13:45:35Z",
      "native_id": "8af2bdf940dc4936baf41769d812b81c",
      "source": "doaj",
      "url": "https://doi.org/10.1186/s12872-026-06336-0"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Diabetes, Cardiovascular Risks, and Lipoproteins",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Associations of estimated glucose disposal rate with chest pain prevalence and mortality risks: a population-based study.",
  "title_text": "Associations of estimated glucose disposal rate with chest pain prevalence and mortality risks: a population-based study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:45:35Z",
  "url": "https://research.draconitic.com/paper/b07bc7sd017hx",
  "venue": "BMC cardiovascular disorders",
  "versions": []
}