The association of glucose disposal rate on cancer odds mediated by composite inflammatory biomarkers: a cross-sectional study.

BACKGROUND

Existing studies have demonstrated a close association between diabetes mellitus and the occurrence and progression of tumors; however, the impact of estimated glucose disposal rate (eGDR) on cancer odds in the general population remains unclear, particularly the potential mediating role of chronic inflammation in this relationship. This study aimed to explore the association between eGDR and cancer odds, and to examine the mediating effect of composite inflammatory biomarkers as indicators of systemic chronic inflammation.

METHODS

This study was based on data from the National Health and Nutrition Examination Survey (NHANES), a large cross-sectional prospective cohort. Waist circumference (cm), hypertension status, glycated hemoglobin (HbA1c) levels, and blood inflammatory markers were collected from 6735 participants, and eGDR and related composite inflammatory indicators were calculated. Weighted multivariable logistic regression models and restricted cubic spline analysis were employed to assess the association between eGDR and cancer odds. Causal mediation analysis was conducted to identify and quantify the mediating role of composite inflammatory biomarkers, and sensitivity analysis was performed to evaluate the robustness of the results.

RESULTS

The study revealed a significant inverse dose-response relationship between eGDR and cancer odds. In the fully adjusted model, compared with the lowest eGDR quartile (Q1), the highest eGDR quartile (Q4) was associated with a 48% significant reduction in cancer odds (OR = 0.52, 95% CI: 0.33-0.81, p = 0.004). This association was independent of demographic factors, sociological factors, and other risk factors. Causal mediation analysis indicated that the composite inflammatory biomarkers neutrophil to lymphocyte ratio (NLR) and neutrophil percentage to albumin ratio (NPAR) exerted mediating effects in the relationship between eGDR and cancer, with mediating proportions of 7% and 11%, respectively (p < 0.01).

CONCLUSION

This study confirmed that higher eGDR is associated with a significantly reduced cancer odds, and this relationship is partially mediated by NLR and NPAR (representing systemic chronic inflammatory status and nutritional status). The results remained robust across multiple models and subgroup analyses, suggesting that increased eGDR may reduce cancer odds partly by inhibiting chronic inflammation. These findings provide epidemiological evidence for the potential role of eGDR in cancer prevention and early screening strategies.