Work

Association between estimated glucose disposal rate and cardiovascular mortality in postmenopausal women: a national cohort study

Year: 2026

Type: article

Abstract: BACKGROUND: The association between estimated glucose disposal rate (eGDR) and cardiovascular mortality in postmenopausal women remains unclear. METHODS: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 1999 to 2018. Participants were stratified by eGDR levels (< 4, 4–6, 6–8, and ≥ 8 mg/kg/min). Survey-weighted Cox proportional hazards models estimated risks of cardiovascular mortality and all-cause mortality, and logistic regression was used to evaluate the risk of having a 10-year predicted cardiovascular disease (CVD) risk ≥ 20%. RESULTS: The study enrolled 7,788 postmenopausal women with a mean age of 60.5 years. During a median follow-up of 9.1 (IQR: 4.8–14.3) years, 414 cardiovascular deaths occurred (3.9%). Compared with the reference group (eGDR < 4 mg/kg/min), multivariable-adjusted hazard ratios (95% CIs) for cardiovascular mortality were 0.37 (0.20–0.67), 0.29 (0.12–0.67), and 0.29 (0.12–0.72) for eGDR categories of 4–6, 6–8, and ≥ 8 mg/kg/min, respectively. A negative linear dose-response relationship was observed. Similar inverse associations were found for all-cause mortality and for having a predicted 10-year CVD risk ≥ 20%, with lower eGDR consistently predicting worse outcomes. CONCLUSION: Lower eGDR, reflecting higher insulin resistance, was independently associated with increased cardiovascular mortality risk among postmenopausal women. These findings support the potential utility of eGDR as a practical biomarker for early cardiovascular mortality risk stratification.

Source: Nutrition & Metabolism

DOI: 10.1186/s12986-026-01096-2