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Background <p>The estimated glucose disposal rate (eGDR), a novel composite indicator for assessing insulin resistance (IR), remains underexplored for its ability to predict the risk of chronic kidney disease (CKD) in individuals with diabetes or prediabetes.</p> Method <p>A total of 17,595 patients with diabetes or prediabetes from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 were included. CKD is defined based on the estimated glomerular filtration rate and the urine albumin-to-creatinine ratio. The calculation of eGDR is based on the waist circumference, hypertension status and glycated hemoglobin. Multivariable logistic regression was used to evaluate the association between eGDR and CKD. Restricted cubic spline (RCS) regression was used to assess dose-response relationships. Subgroup analysis explores the differences in effects among different populations. Mediating analysis was used to quantify the role of serum uric acid (SUA) in the eGDR-CKD association. Receiver operating characteristic curve (ROC) curves were used to compare the predictive performance of eGDR with that of other IR indices.</p> Results <p>After full adjustment, the eGDR showed a significant inverse association with CKD risk. The RCS curves confirmed a linear negative relationship between eGDR and CKD. Subgroup analysis revealed stronger associations in men. Mediation analysis indicated that SUA partially mediated the eGDR-CKD association, accounting for 6.2% of the total effect. ROC analysis revealed that the eGDR shad a moderate predictive ability for CKD in patients with diabetes or prediabetes.</p> Conclusion <p>This cross-sectional study confirmed that the eGDR is linearly negatively correlated with CKD in a population with diabetes or prediabetes and that its discriminative power is moderate but superior to that of traditional IR indicators. The statistical overlap of SUA on the total association was approximately 6.2%, but the mediating effect was fragile. This finding should be verified in prospective cohorts in the future.</p>

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Serum uric acid mediates the association between the estimated glucose disposal rate and chronic kidney disease in patients with diabetes or prediabetes: an analysis from NHANES 2005–2018

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  • 发表日期：

    2025年11月13日

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  • Jinming Yin,
  • Meiling Luo,
  • Qingan Fu,
  • Huangxin Zhu

摘要

Background

The estimated glucose disposal rate (eGDR), a novel composite indicator for assessing insulin resistance (IR), remains underexplored for its ability to predict the risk of chronic kidney disease (CKD) in individuals with diabetes or prediabetes.

Method

A total of 17,595 patients with diabetes or prediabetes from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 were included. CKD is defined based on the estimated glomerular filtration rate and the urine albumin-to-creatinine ratio. The calculation of eGDR is based on the waist circumference, hypertension status and glycated hemoglobin. Multivariable logistic regression was used to evaluate the association between eGDR and CKD. Restricted cubic spline (RCS) regression was used to assess dose-response relationships. Subgroup analysis explores the differences in effects among different populations. Mediating analysis was used to quantify the role of serum uric acid (SUA) in the eGDR-CKD association. Receiver operating characteristic curve (ROC) curves were used to compare the predictive performance of eGDR with that of other IR indices.

Results

After full adjustment, the eGDR showed a significant inverse association with CKD risk. The RCS curves confirmed a linear negative relationship between eGDR and CKD. Subgroup analysis revealed stronger associations in men. Mediation analysis indicated that SUA partially mediated the eGDR-CKD association, accounting for 6.2% of the total effect. ROC analysis revealed that the eGDR shad a moderate predictive ability for CKD in patients with diabetes or prediabetes.

Conclusion

This cross-sectional study confirmed that the eGDR is linearly negatively correlated with CKD in a population with diabetes or prediabetes and that its discriminative power is moderate but superior to that of traditional IR indicators. The statistical overlap of SUA on the total association was approximately 6.2%, but the mediating effect was fragile. This finding should be verified in prospective cohorts in the future.