Abstract
OBJECTIVE: To examine the association between estimated glucose disposal rate (eGDR) and the prevalence of self-reported heart failure among patients with diabetes or prediabetes from the National Health and Nutrition Examination Survey (NHANES). METHODS: This cross-sectional study selected data from eight cycles (one every two years) of the NHANES study from 2003 to 2018 and included 9,017 participants. Tertiles of calculated eGDR initially grouped patients with diabetes and prediabetes. Weighted multivariate logistic regression models were then utilized to investigate the correlation between varying levels of eGDR and the prevalence of self-reported heart failure. Subsequently, smoothed fit curves were employed to assess a potential association between cumulative eGDR and the prevalence of self-reported heart failure. Finally, subgroup analyses were conducted. RESULTS: In the final analysis of all 9,017 participants who met the study requirements in the fully covariate-adjusted model, eGDR was found to be linearly and negatively associated with the incidence of heart failure among US patients with diabetes or prediabetes (P non-linear = 0.5424). Furthermore, in the fully covariate-adjusted continuous model, each 1-unit increase in eGDR was associated with a 23% reduction in the risk of heart failure (odds ratio [OR]: 0.77, 95% confidence interval [CI]: 0.69-0.85, p < 0.0001). In the fully covariate-adjusted categorical model, participants in the highest tertile (Q3) exhibited a 69% lower risk of developing heart failure compared to those in the lowest tertile (Q1) (OR: 0.31, 95% CI: 0.17-0.57, p < 0.001). Subgroup analyses revealed the potential for an interaction in ethnic subgroups. CONCLUSION: The present study established a significant negative correlation between the eGDR levels and the incidence of heart failure in US patients with diabetes or prediabetes. This suggests that eGDR may have a potential role in associated with the prevalence of heart failure in the overall population. It is also noteworthy that eGDR is associated with the onset of several diseases.