Mediating role of estimated glomerular filtration rate in the association between hyperlipidemia and estimated glucose disposal rate-related mortality: a study in hyperlipidemic individuals.

BACKGROUND AND AIMS: Hyperlipidemia is a well-established risk factor for cardiovascular disease (CVD) and all-cause mortality. The estimated glucose disposal rate (eGDR), a non-invasive marker of insulin resistance, has shown potential in predicting CVD outcomes. However, its association with mortality in individuals with hyperlipidemia remains unclear. This study aimed to investigate the relationship between eGDR and both all-cause and CVD-specific mortality in a hyperlipidemic population.

METHODS AND RESULTS: The present study used data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 to calculate the eGDR in a sample of 9283 adults diagnosed with hyperlipidaemia. Participants were stratified into eGDR quartiles (Q1-Q4). Cox regression was employed to assess mortality risks.Especially significant in subgroup analysis for patients under 60 years of age.Lower eGDR quartiles exhibited metabolic profiles that were indicative of poorer health and elevated mortality rates (all-cause: Q1 = 13.08% vs. Q4 = 3.07%; CVD: 4.06% vs. 0.48%). An increase of one unit in the eGDR was associated with a 7% reduction in all-cause mortality (HR = 0.93) and a 14% reduction in CVD mortality (HR = 0.86). In comparison with the first quarter, the fourth quarter exhibited a 40% decrease in all-cause mortality (hazard ratio [HR] = 0.60) and a 56% decrease in CVD mortality (HR = 0.44). Mediation analyses implicated eGFR(36.5%) in these associations.

CONCLUSION: In patients suffering from hyperlipidaemia in the US, a decrease in eGDR has been shown to be associated with an increased risk of all-cause and cardiovascular disease mortality.