ORIGINAL RESEARCH article
Front. Med.
Sec. Hepatobiliary Diseases
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1589245
Associations of estimated glucose disposal rate with risk of futureincident metabolic dysfunction-associated steatotic liver disease and other chronic liver diseases: a prospective cohort study
Provisionally accepted
- People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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Background: The incidence of insulin resistance, as determined by estimated glucose disposal rate (eGDR), is associated with various morbidities. The relationship between eGDR and chronic liver diseases remains to be explored. This study examined the association between eGDR and the risk of future metabolic dysfunction-associated steatotic liver disease (MASLD), cirrhosis, liver cancer, and liver-related mortality.Method: We analyzed data from UK Biobank participants with no history of liver diseases. We calculated the eGDR values for each participant and divided them into four quartile groups based on these values. The primary outcome was MASLD, whereas the secondary outcomes included cirrhosis, liver cancer, and liver-related mortality. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazard regression models. We used restricted cubic splines models to detect potential non-linear relationships.Results: This study included data from 290,397 UK Biobank participants who had no history of liver diseases, and the magnetic resonance imaging (MRI)-derived liver proton density fat fraction (PDFF) analysis included 25,810 individuals. Over a median follow-up period of 15.69 years, we identified 3,926 cases of MASLD, 1,553 cases of cirrhosis, 167 cases of liver cancer, and 120 cases of liver-related mortality. After adjusting for multiple variables, higher eGDR levels were significantly associated with a lower risk of MASLD (HR: 0.83, 95% CI: 0.90–0.93), cirrhosis (HR: 0.89, 95% CI: 0.86–0.92), and liver cancer (HR: 0.91, 95% CI: 0.83–1.00). Comparing participants between the lowest and highest quartiles (Q1 and Q4) of eGDR, Q4 had a 47% lower risk of MASLD (HR: 0.53; 95% CI: 0.45–0.63), with similar results for cirrhosis. Moreover, high eGDR levels were associated with a low risk of MASLD based on MRI-derived liver PDFF >5% (odds ratio: 0.98, 95% CI: 0.97–0.98).Conclusions: We found a significant inverse correlation between eGDR and MASLD, cirrhosis, and liver cancer. Incorporating eGDR into clinical decision-making can improve the long term follow-up of patients with MASLD.
Keywords: Metabolic metabolic dysfunction-associated steatotic liver disease, Metabolic metabolic dysfunction-associated steatohepatitis, Insulin insulin resistance, Estimated estimated glucose disposal rate, Liver liver Cirrhosiscirrhosis, Liver liver Neoplasmsneoplasms, Metabolicmetabolic, Epidemiologyepidemiology
Received: 13 Mar 2025; Accepted: 19 Jun 2025.
Copyright: © 2025 Li, Ye and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaoyu Chen, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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