Estimated glucose disposal rate as a practical tool for non-alcoholic fatty liver disease identification: A NHANES-based cross-sectional study uncovering its protective threshold

WANG Shangyu; JIA Peng; YANG Xiaojiao; LAI Quanyou

doi:10.16016/j.2097-0927.202508015

您当前的位置：

首页 >

文章列表页 >

Estimated glucose disposal rate as a practical tool for non-alcoholic fatty liver disease identification: A NHANES-based cross-sectional study uncovering its protective threshold

Think Tank for Public Health | 更新时间：2025-11-28

- Estimated glucose disposal rate as a practical tool for non-alcoholic fatty liver disease identification: A NHANES-based cross-sectional study uncovering its protective threshold
- Journal of Army Medical University Vol. 47, Issue 22, Pages: 2837-2846(2025)
- 作者机构：
  
  1.空军军医大学第一附属医院肝胆胰脾外科，陕西西安
  2.中国人民解放军94750部队医院外科，福建龙岩
- 作者简介：
  
  LAI Quanyou，E-mail：laiqy@pku.org.cn
- 基金信息：
- DOI：10.16016/j.2097-0927.202508015
  CLC： R181.23;R194.3;R575.5
- Received：05 August 2025，
  
  Revised：2025-11-04，
  
  Accepted：05 November 2025，
  
  Published：30 November 2025
- 稿件说明：
移动端阅览
王尚毓，贾鹏，杨晓佼，等.估计葡萄糖处理率作为非酒精性脂肪性肝病的便捷识别工具：一项基于NHANES的横断面研究揭示其保护性阈值［J］.陆军军医大学学报，2025，47（22）：2837-2846.DOI：10.16016/j.2097-0927.202508015.

WANG S Y，JIA P，YANG X J，et al.Estimated glucose disposal rate as a practical tool for non-alcoholic fatty liver disease identification： A NHANES-based cross-sectional study uncovering its protective threshold［J］.J Army Med Univ，2025，47（22）：2837-2846.DOI：10.16016/j.2097-0927.202508015.
王尚毓，贾鹏，杨晓佼，等.估计葡萄糖处理率作为非酒精性脂肪性肝病的便捷识别工具：一项基于NHANES的横断面研究揭示其保护性阈值［J］.陆军军医大学学报，2025，47（22）：2837-2846.DOI：10.16016/j.2097-0927.202508015. DOI：

WANG S Y，JIA P，YANG X J，et al.Estimated glucose disposal rate as a practical tool for non-alcoholic fatty liver disease identification： A NHANES-based cross-sectional study uncovering its protective threshold［J］.J Army Med Univ，2025，47（22）：2837-2846.DOI：10.16016/j.2097-0927.202508015. DOI：

摘要

目的

探讨估计葡萄糖处理率（estimated glucose disposal rate，eGDR）对非酒精性脂肪性肝病（non-alcoholic fatty liver disease，NAFLD）的早期识别价值，为临床精准干预提供简便工具。

方法

通过横断面分析的方法，从美国国家健康和营养调查数据库中纳入来自2007—2018年共计3 262名具有完整数据的参与者进行分析。采用单因素回归和多元Logistic回归分析探讨估计葡萄糖处理率与非酒精性脂肪肝发病率的相关性，通过亚组分析、限制性三次样条和阈值效应分析探究潜在的因素影响和非线性关系。

结果

在所有纳入人群中，948例（25.29%）被诊断为NAFLD，并随着估计葡萄糖处理率的增加人数而逐渐减少（

0.001）。多元logistic回归显示，估计葡萄糖处理率和非酒精性脂肪肝呈负向相关（

=0.86，95%

：0.83~0.88，

0.001），且估计葡萄糖处理率≥10.246时可显著降低非酒精性脂肪肝的发生风险（

=0.20，95%：0.10~0.39，

0.001），分层分析进一步证实了这一结果。

结论

更高的eGDR水平预示着更低的NAFLD患病风险。这提示在临床实践中，通过量化eGDR指标，有助于识别NAFLD的患病风险，从而更早地发现潜在患病人群并实施针对性干预。对策建议有关部门将eGDR 这一指标纳入公共卫生防控体系，通过社区筛查构建数据驱动的风险分层管理路径；同时将NAFLD防治整合进现有慢性病管理网络，推动多部门协作制定健康饮食与运动支持政策，并加强疾病监测、药物研发与综合干预，从而实现对高危人群的早期识别与精准管理，全面降低NAFLD的疾病负担。

Abstract

Objective

To explore the early detection value of estimated glucose disposal rate (eGDR) for non-alcoholic fatty liver disease (NAFLD)

providing a simple tool for precise clinical intervention.

Methods

A cross-sectional analysis was conducted on totally 3 262 participants with complete data from the National Health and Nutrition Survey Database of the United States from 2007 to 2018. Univariate regression and multivariate logistic regression analyses were used to explore the correlation between the estimated glucose treatment rate and the incidence of non-alcoholic fatty liver disease. Subgroup analysis

restricted cubic spline and threshold effect analysis were conducted to investigate the potential factor influences and nonlinear relationships.

Result

Among all the included populations

948 cases (25.29%) were diagnosed with NAFLD

and the number gradually decreased with the increase of the estimated glucose treatment rate (

0.001). Multivariate logistic regression showed that the estimated grape processing rate was negatively correlated with non-alcoholic fatty liver disease (

=0.86

95%

:0.83~0.88

0.001)

and when the estimated glucose processing rate was ≥10.246

it could significantly reduce the risk of non-alcoholic fatty liver disease (

=0.20

95%

:0.10~0.39

0.001)

and stratified analysis further confirmed this result.

Conclusion

The eGDR is significantly associated with the incidence risk of NAFLD. A higher eGDR indicates a lower risk of NAFLD. This implies that in clinical practice

the risk of disease detection can be quantified through this indicator

thereby identifying potential patients earlier and initiating intervention. Countermeasures　As decision-makers

they should strengthen public health education on non-alcoholic fatty liver disease

reduce health risks by promoting healthy diets and lifestyle interventions

and pay attention to the cardiovascular health of high-risk groups for non-alcoholic fatty liver disease. At the same time

promote the research and application of drugs

and dynamically adjust policies through continuous disease monitoring to comprehensively reduce the burden of non-alcoholic fatty liver disease.

关键词

Keywords

references

YOUNOSSI Z ， ANSTEE Q M ， MARIETTI M ， et al . Global burden of NAFLD and NASH： trends， predictions， risk factors and prevention ［J］. Nat Rev Gastroenterol Hepatol ， 2018 ， 15 （ 1 ）： 11 - 20 . DOI： 10.1038/nrgastro.2017.109 http://dx.doi.org/10.1038/nrgastro.2017.109 .

LE M H ， YEO Y H ， LI X H ， et al . 2019 global NAFLD prevalence： a systematic review and meta-analysis ［J］. Clin Gastroenterol Hepatol ， 2022 ， 20 （ 12 ）： 2809 - 2817.e28 . DOI： 10.1016/j.cgh.2021.12.002 http://dx.doi.org/10.1016/j.cgh.2021.12.002 .

RONG L ， ZOU J Y ， RAN W ， et al . Advancements in the treatment of non-alcoholic fatty liver disease （NAFLD）［J］. Front Endocrinol ， 2022 ， 13 ： 1087260 . DOI： 10.3389/fendo.2022.1087260 http://dx.doi.org/10.3389/fendo.2022.1087260 .

BONORA E ， TARGHER G ， ALBERICHE M ， et al . Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity： studies in subjects with various degrees of glucose tolerance and insulin sensitivity ［J］. Diabetes Care ， 2000 ， 23 （ 1 ）： 57 - 63 . DOI： 10.2337/diacare.23.1.57 http://dx.doi.org/10.2337/diacare.23.1.57 .

WILLIAMS K V ， ERBEY J R ， BECKER D ， et al . Can clinical factors estimate insulin resistance in type 1 diabetes ［J］. Diabetes ， 2000 ， 49 （ 4 ）： 626 - 632 . DOI： 10.2337/diabetes.49.4.626 http://dx.doi.org/10.2337/diabetes.49.4.626 .

ZHANG Z L ， ZHAO L ， LU Y T ， et al . Insulin resistance assessed by estimated glucose disposal rate and risk of incident cardiovascular diseases among individuals without diabetes： findings from a nationwide， population based， prospective cohort study ［J］. Cardiovasc Diabetol ， 2024 ， 23 （ 1 ）： 194 . DOI： 10.1186/s12933-024-02256-5 http://dx.doi.org/10.1186/s12933-024-02256-5 .

PENG J ， ZHANG Y ， ZHU Y Q ， et al . Estimated glucose disposal rate for predicting cardiovascular events and mortality in patients with non-diabetic chronic kidney disease： a prospective cohort study ［J］. BMC Med ， 2024 ， 22 （ 1 ）： 411 . DOI： 10.1186/s12916-024-03582-x http://dx.doi.org/10.1186/s12916-024-03582-x .

EDDOWES P J ， SASSO M ， ALLISON M ， et al . Accuracy of FibroScan controlled attenuation parameter and liver stiffness measurement in assessing steatosis and fibrosis in patients with nonalcoholic fatty liver disease ［J］. Gastroenterology ， 2019 ， 156 （ 6 ）： 1717 - 1730 . DOI： 10.1053/j.gastro.2019. 01.042 http://dx.doi.org/10.1053/j.gastro.2019.01.042 .

RUHL C E ， EVERHART J E . Fatty liver indices in the multiethnic United States National Health and Nutrition Examination Survey ［J］. Aliment Pharmacol Ther ， 2015 ， 41 （ 1 ）： 65 - 76 . DOI： 10.1111/apt.13012 http://dx.doi.org/10.1111/apt.13012 .

SONG J T ， MA R C ， YIN L . Associations between estimated glucose disposal rate and arterial stiffness and mortality among US adults with non-alcoholic fatty liver disease ［J］. Front Endocrinol ， 2024 ， 15 ： 1398265 . DOI： 10.3389/fendo.2024.1398265 http://dx.doi.org/10.3389/fendo.2024.1398265 .

RIAZI K ， AZHARI H ， CHARETTE J H ， et al . The prevalence and incidence of NAFLD worldwide： a systematic review and meta-analysis ［J］. Lancet Gastroenterol Hepatol ， 2022 ， 7 （ 9 ）： 851 - 861 . DOI： 10.1016/S2468-1253（22）00165-0 http://dx.doi.org/10.1016/S2468-1253（22）00165-0 .

ZIAMANESH F ， MOHAMMADI M ， EBRAHIMPOUR S ， et al . Unraveling the link between insulin resistance and non-alcoholic fatty liver disease （or metabolic dysfunction-associated steatotic liver disease）： a narrative review ［J］. J Diabetes Metab Disord ， 2023 ， 22 （ 2 ）： 1083 - 1094 . DOI： 10.1007/s40200-023-01293-3 http://dx.doi.org/10.1007/s40200-023-01293-3 .

ALFERINK L J ， KIEFTE-DE JONG J C ， ERLER N S ， et al . Association of dietary macronutrient composition and non-alcoholic fatty liver disease in an ageing population： the Rotterdam Study ［J］. Gut ， 2019 ， 68 （ 6 ）： 1088 - 1098 . DOI： 10.1136/gutjnl-2017-315940 http://dx.doi.org/10.1136/gutjnl-2017-315940 .

GORDITO SOLER M ， LÓPEZ-GONZÁLEZ Á A ， VALLEJOS D ， et al . Usefulness of body fat and visceral fat determined by bioimpedanciometry versus body mass index and waist circumference in predicting elevated values of different risk scales for non-alcoholic fatty liver disease ［J］. Nutrients ， 2024 ， 16 （ 13 ）： 2160 . DOI： 10.3390/nu16132160 http://dx.doi.org/10.3390/nu16132160 .

ZIOLKOWSKA S ， BINIENDA A ， JABŁKOWSKI M ， et al . The interplay between insulin resistance， inflammation， oxidative stress， base excision repair and metabolic syndrome in nonalcoholic fatty liver disease ［J］. Int J Mol Sci ， 2021 ， 22 （ 20 ）： 11128 . DOI： 10.3390/ijms222011128 http://dx.doi.org/10.3390/ijms222011128 .

BANG K B ， CHO Y K . Comorbidities and metabolic derangement of NAFLD ［J］. J Lifestyle Med ， 2015 ， 5 （ 1 ）： 7 - 13 . DOI： 10.15280/jlm.2015.5.1.7 http://dx.doi.org/10.15280/jlm.2015.5.1.7 .

ASSY N ， KAITA K ， MYMIN D ， et al . Fatty infiltration of liver in hyperlipidemic patients ［J］. Dig Dis Sci ， 2000 ， 45 （ 10 ）： 1929 - 1934 . DOI： 10.1023/a： 1005661516165 http://dx.doi.org/10.1023/a：1005661516165 .

RYOO J H ， SUH Y J ， SHIN H C ， et al . Clinical association between non-alcoholic fatty liver disease and the development of hypertension ［J］. J Gastroenterol Hepatol ， 2014 ， 29 （ 11 ）： 1926 - 1931 . DOI： 10.1111/jgh.12643 http://dx.doi.org/10.1111/jgh.12643 .

CAPALDO B ， LEMBO G ， NAPOLI R ， et al . Skeletal muscle is a primary site of insulin resistance in essential hypertension ［J］. Metabolism ， 1991 ， 40 （ 12 ）： 1320 - 1322 . DOI： 10.1016/0026-0495（91）90036-V http://dx.doi.org/10.1016/0026-0495（91）90036-V .

MANTOVANI A ， PETRACCA G ， BEATRICE G ， et al . Non-alcoholic fatty liver disease and risk of incident chronic kidney disease： an updated meta-analysis ［J］. Gut ， 2022 ， 71 （ 1 ）： 156 - 162 . DOI： 10.1136/gutjnl-2020-323082 http://dx.doi.org/10.1136/gutjnl-2020-323082 .

NAH E H ， SHIN S K ， CHO S ， et al . Chronic kidney disease in nonalcoholic fatty liver disease at primary healthcare centers in Korea ［J］. PLoS One ， 2022 ， 17 （ 12 ）： e0279367 . DOI： 10.1371/journal.pone.0279367 http://dx.doi.org/10.1371/journal.pone.0279367 .

CAO Y ， DU Y W ， JIA W L ， et al . Identification of biomarkers for the diagnosis of chronic kidney disease （CKD） with non-alcoholic fatty liver disease （NAFLD） by bioinformatics analysis and machine learning ［J］. Front Endocrinol ， 2023 ， 14 ： 1125829 . DOI： 10.3389/fendo.2023.1125829 http://dx.doi.org/10.3389/fendo.2023.1125829 .

HAN Y T ， ZHANG K X ， LUO Y ， et al . Relationship between stroke and estimated glucose disposal rate： results from two prospective cohort studies ［J］. Lipids Health Dis ， 2024 ， 23 （ 1 ）： 392 . DOI： 10.1186/s12944-024-02385-6 http://dx.doi.org/10.1186/s12944-024-02385-6 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

p300 promotes hepatic lipid accumulation in dyslipidemia by regulating SREBP-1c acetylation

S-Equol improves type 2 diabetes mellitus combined with nonalcoholic fatty liver disease by regulating SREBP pathway and PPARγ in rats

Effect of equol intervention on high-fat diet-induced non-alcoholic fatty liver disease in ovariectomized rats

Effects of dietary fatty acids on expression of gene sterol-regulatory elementary binding protein-1c and occurrence of non-alcoholic fatty liver disease in rats

Association of SIRT3 gene variation with risk of non-alcoholic fatty liver disease and functional study of the gene in a mouse model

Related Author

ZENG Menghua

NUHU Abdul-Rauf Nyewneh

LI Xiaoli

FANG Lu

CAI Yongqing

CHEN Fei

YUAN Lie

YANG Xiong

Related Institution

达州市中西医结合医院药学科

陆军军医大学大坪医院药剂科

Chongqing Key Laboratory of Biochemistry and Molecular Pharmacology，Chongqing；⁴Department of Pharmacy，Daping Hospital，Army Medical University （Third Military Medical University）， Chongqing； ⁵Department of Pharmacy，Dazhou Hospital of Integrated Traditional Chinese and Western Medicine

Department of Gastrointestinal Surgery，the First Affiliated Hospital of Chongqing Medical University

College of Pharmacy，Chongqing Medical University

⁰