Work

Estimated glucose disposal rate and mortality in patients with cardiovascular disease: findings from two large cohorts

Year: 2026

Type: article

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.

Source: Open Heart

DOI: 10.1136/openhrt-2026-004434