Association between android-to-gynoid lean mass ratio and advanced cardiovascular-kidney-metabolic syndrome, and the cross-sectional association decomposition of estimated glucose disposal rate.
4 affiliations
- 1Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
- 2Beijing Institute of Petrochemical Engineering, Beijing, China.
- 3Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China. Electronic address: [email protected].
- 4Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China. Electronic address: [email protected].
Abstract
Background
The Android-to-Gynoid Lean Mass (LM) Ratio (AGLR) reflects the distribution of body LM and may influence the risk of advanced Cardiovascular-Kidney-Metabolic (CKM) syndrome. However, the extent to which Insulin Resistance (IR), as indicated by the estimated Glucose Disposal Rate (eGDR), explains the association between AGLR and advanced CKM syndrome remains unclear. This study aims to elucidate the relationship between AGLR and advanced CKM syndrome and to determine the contribution of eGDR to this association.Methods
7,399 participants from the 2003‒2006 and 2011‒2018 cycles of the National Health and Nutrition Examination Survey (NHANES) were included in this cross-sectional study. The association between AGLR and advanced CKM syndrome was assessed using weighted Logistic Regression (LR) and subgroup analyses. The potential relationship was further examined using Restricted Cubic Splines (RCS). Sensitivity analyses were conducted to evaluate the robustness of the findings. Cross-sectional decomposition analysis was performed to quantify the contribution of eGDR to the observed associations.Results
Higher AGLR was associated with stage 4 of CKM syndrome (OR = 1.83, 95% CI: 1.34‒2.50, p < 0.001). For stage 3, the overall trend across quartiles was not significant, indicating a less robust association. Reverse causality cannot be excluded. RCS analysis revealed a positive linear relation (p for nonlinear = 0.681). Subgroup analyses suggested that interactions were statistically insignificant across subgroups. Cross-sectional decomposition analysis showed that eGDR statistically accounted for 33.71% of the association. Notably, given shared components and the cross-sectional design, this should not be interpreted as causal mediation.Conclusion
LM distribution is relevant to CKM syndrome progression. IR, as reflected by eGDR, may represent a key underlying pathological mechanism.
Related
- Association of estimated plasma volume status with progression from stage 2 to stage 4 cardiovascular–kidney–metabolic syndrome: a cohort from the Tianjin region of China
- Estimated glucose disposal rate stratifies mortality risk, especially in younger adults with cardiovascular-liver-metabolic overlap.
- Estimated glucose disposal rate shows the broadest associations with cardiometabolic multimorbidity progression in early cardiovascular–kidney–metabolic stages: a longitudinal cohort study
- Estimated glucose disposal rate outperforms other insulin resistance surrogate indices in predicting cardiometabolic disease and major adverse cardiovascular events in metabolic dysfunction-associated steatotic liver disease: insights from UK Biobank
- Association between estimated glucose disposal rate and history of cataract surgery : A population-based cross-sectional study from NHANES
BibTeX
@article{zhang2026association,
title = {{Association between android-to-gynoid lean mass ratio and advanced cardiovascular-kidney-metabolic syndrome, and the cross-sectional association decomposition of estimated glucose disposal rate.}},
author = {Ye Zhang and Rui Zhuang and Zheng Zhuo and Chaofeng Niu and Chenxi Xu and Xuetong Wang and Bing Li and Ce Wang and Lijing Zhang and Meng Li},
journal = {Clinics (Sao Paulo, Brazil)},
year = {2026},
month = oct,
doi = {10.1016/j.clinsp.2026.101170},
url = {https://europepmc.org/article/MED/42880123},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association between android-to-gynoid lean mass ratio and advanced cardiovascular-kidney-metabolic syndrome, and the cross-sectional association decomposition of estimated glucose disposal rate.
AU - Ye Zhang
AU - Rui Zhuang
AU - Zheng Zhuo
AU - Chaofeng Niu
AU - Chenxi Xu
AU - Xuetong Wang
AU - Bing Li
AU - Ce Wang
AU - Lijing Zhang
AU - Meng Li
PY - 2026
DA - 2026/10/15
JO - Clinics (Sao Paulo, Brazil)
DO - 10.1016/j.clinsp.2026.101170
UR - https://europepmc.org/article/MED/42880123
AB - Background The Android-to-Gynoid Lean Mass (LM) Ratio (AGLR) reflects the distribution of body LM and may influence the risk of advanced Cardiovascular-Kidney-Metabolic (CKM) syndrome. However, the extent to which Insulin Resistance (IR), as indicated by the estimated Glucose Disposal Rate (eGDR), explains the association between AGLR and advanced CKM syndrome remains unclear. This study aims to elucidate the relationship between AGLR and advanced CKM syndrome and to determine the contribution of eGDR to this association.Methods 7,399 participants from the 2003‒2006 and 2011‒2018 cycles of the National Health and Nutrition Examination Survey (NHANES) were included in this cross-sectional study. The association between AGLR and advanced CKM syndrome was assessed using weighted Logistic Regression (LR) and subgroup analyses. The potential relationship was further examined using Restricted Cubic Splines (RCS). Sensitivity analyses were conducted to evaluate the robustness of the findings. Cross-sectional decomposition analysis was performed to quantify the contribution of eGDR to the observed associations.Results Higher AGLR was associated with stage 4 of CKM syndrome (OR = 1.83, 95% CI: 1.34‒2.50, p < 0.001). For stage 3, the overall trend across quartiles was not significant, indicating a less robust association. Reverse causality cannot be excluded. RCS analysis revealed a positive linear relation (p for nonlinear = 0.681). Subgroup analyses suggested that interactions were statistically insignificant across subgroups. Cross-sectional decomposition analysis showed that eGDR statistically accounted for 33.71% of the association. Notably, given shared components and the cross-sectional design, this should not be interpreted as causal mediation.Conclusion LM distribution is relevant to CKM syndrome progression. IR, as reflected by eGDR, may represent a key underlying pathological mechanism.
SN - 1807-5932
SN - 1980-5322
ER -