Estimated glucose disposal rate and mortality in patients with cardiovascular disease: findings from two large cohorts
- 1Department of Integrative Medicine Cardiology, China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Beijing, People's Republic of China
- 2Department of Integrative Medicine Cardiology, China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
- 3Department of Cardiology, Fuwai Hospital, Beijing, China
Abstract
Background: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide. Insulin resistance contributes to adverse cardiovascular outcomes but conventional assessments are complex and not routinely available. The estimated glucose disposal rate (eGDR), a simple surrogate of insulin resistance, may provide prognostic information in patients with established CVD.
Methods: Adults with CVD were identified from the National Health and Nutrition Examination Survey (NHANES) (n=4283) as the primary cohort and from a predefined UK Biobank (UKB) subcohort (n=31 460) as the replication cohort. Cox models, restricted cubic splines, Kaplan-Meier curves and subgroup analyses were used to evaluate associations between eGDR and mortality.
Results: During median follow-ups of 7.8 and 14.2 years, 1886 and 2218 deaths occurred in NHANES and the UKB, including 634 and 616 cardiovascular deaths, respectively. In fully adjusted models, higher continuous eGDR was associated with lower all-cause mortality in NHANES (HR, 0.859; 95% CI 0.800 to 0.923; p<0.001) and the UKB (HR, 0.792; 95% CI 0.743 to 0.844; p<0.001). Similar associations were observed for cardiovascular mortality in NHANES (HR, 0.844; 95% CI 0.736 to 0.969; p=0.016) and the UKB (HR, 0.737; 95% CI 0.656 to 0.828; p<0.001). Spline analyses showed non-linear inverse associations with both mortality outcomes in NHANES. In the UKB, the association with all-cause mortality became non-linear after multivariable adjustment, whereas the association with cardiovascular mortality was approximately linear.
Conclusion: Higher eGDR was independently associated with lower all-cause and cardiovascular mortality in patients with CVD, supporting its potential as a simple marker for mortality risk stratification.
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BibTeX
@article{zhao2026estimated,
title = {{Estimated glucose disposal rate and mortality in patients with cardiovascular disease: findings from two large cohorts}},
author = {Lin Zhao and Danni Wu and Zenglei Zhang and Tianli Li and Tong Gao and Song Wu and Baofu Wang and Mengru Liu and Peng Yang and Jiangshan Tan and Xianlun Li},
journal = {Open Heart},
year = {2026},
month = oct,
doi = {10.1136/openhrt-2026-004434},
url = {https://doi.org/10.1136/openhrt-2026-004434},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Estimated glucose disposal rate and mortality in patients with cardiovascular disease: findings from two large cohorts
AU - Lin Zhao
AU - Danni Wu
AU - Zenglei Zhang
AU - Tianli Li
AU - Tong Gao
AU - Song Wu
AU - Baofu Wang
AU - Mengru Liu
AU - Peng Yang
AU - Jiangshan Tan
AU - Xianlun Li
PY - 2026
DA - 2026/10/28
JO - Open Heart
DO - 10.1136/openhrt-2026-004434
UR - https://doi.org/10.1136/openhrt-2026-004434
AB - Background: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide. Insulin resistance contributes to adverse cardiovascular outcomes but conventional assessments are complex and not routinely available. The estimated glucose disposal rate (eGDR), a simple surrogate of insulin resistance, may provide prognostic information in patients with established CVD. Methods: Adults with CVD were identified from the National Health and Nutrition Examination Survey (NHANES) (n=4283) as the primary cohort and from a predefined UK Biobank (UKB) subcohort (n=31 460) as the replication cohort. Cox models, restricted cubic splines, Kaplan-Meier curves and subgroup analyses were used to evaluate associations between eGDR and mortality. Results: During median follow-ups of 7.8 and 14.2 years, 1886 and 2218 deaths occurred in NHANES and the UKB, including 634 and 616 cardiovascular deaths, respectively. In fully adjusted models, higher continuous eGDR was associated with lower all-cause mortality in NHANES (HR, 0.859; 95% CI 0.800 to 0.923; p<0.001) and the UKB (HR, 0.792; 95% CI 0.743 to 0.844; p<0.001). Similar associations were observed for cardiovascular mortality in NHANES (HR, 0.844; 95% CI 0.736 to 0.969; p=0.016) and the UKB (HR, 0.737; 95% CI 0.656 to 0.828; p<0.001). Spline analyses showed non-linear inverse associations with both mortality outcomes in NHANES. In the UKB, the association with all-cause mortality became non-linear after multivariable adjustment, whereas the association with cardiovascular mortality was approximately linear. Conclusion: Higher eGDR was independently associated with lower all-cause and cardiovascular mortality in patients with CVD, supporting its potential as a simple marker for mortality risk stratification.
SN - 2053-3624
ER -