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. 2025 Mar 11;25(1):67.
doi: 10.1186/s12902-025-01891-7.

The association between estimated glucose disposal rate and metabolic dysfunction-associated steatotic liver disease and liver fibrosis in US adults

Wanqian Liu #  1 , Xiaozhong Li #  2 , Ling Chen  1 , Xiao Luo  3
Affiliations

The association between estimated glucose disposal rate and metabolic dysfunction-associated steatotic liver disease and liver fibrosis in US adults

Wanqian Liu et al. BMC Endocr Disord. .

Abstract

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease, also considered a metabolic syndrome, and is associated with poor prognosis. eGDR (estimated glucose disposal rate) is a new biomarker to assessment insulin resistance (IR). The association between eGDR and MASLD and liver fibrosis is currently unclear.

Objective: The aim of this cross-sectional study is to appraise the association between eGDR and MASLD and liver fibrosis.

Methods: This study have enrolled 3,100 participants from the 2017-2018 National Health and Nutrition Examination Surveys (NHANES). Binary logistic regression analysis was used to assess the association between eGDR and MASLD and liver fibrosis. Receiver operating characteristic (ROC) was applied to estimate the ability of eGDR to identify MASLD.

Results: The mean age of the subjects was 54.59 (17.29) years, and 49.26% were female. The prevalence of MASLD and liver fibrosis was 62.19% and 11.15%, respectively. In the fully adjusted models, there were negative associations of eGDR with the controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), with βs of -15.18 and - 0.74 (all p < 0.01), respectively. There were negative associations of eGDR with MASLD and liver fibrosis, with odds ratios (ORs) and 95% confidence intervals of 0.53 (95% CI: 0.48-0.74) and 0.40 (95% CI: 0.28-0.57) (all p < 0.01). The area under the curve (AUC) of the eGDR for identifying MASLD and liver fibrosis is 0.74 and 0.75, respectively.

Conclusion: The study findings suggest a significant association between eGDR and MASLD as well as liver fibrosis. eGDR may serve as a biomarker for identifying MASLD.

Keywords: Estimated glucose disposal rate; Insulin resistance; Liver fibrosis; Nonalcoholic fatty liver disease.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The studies involving human participants received ethical approval from The Second Affiliated Hospital of Nanchang University Medical Research Ethics Committee. Written informed consent for participation was not required for this study in accordance with national legislation and institutional requirements. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of study selection for this study Abbreviations: NHANES: National Health and Nutrition Examination Survey; CAP: Controlled attenuation parameter; BMI: Body mass index; GH: Glycosylated hemoglobin A1c; eGDR: Estimated glucose disposal rate
Fig. 2
Fig. 2
The correlation between the eGDR and CAP (A) and LSM (B) Abbreviations: eGDR: estimated glucose disposal rate; LSM: liver stiffness measurement
Fig. 3
Fig. 3
The odds ratios and the histogram of the probability distribution for MASLD and liver fibrosis according to eGDR. The red curve with a light black dotted line indicates an adjusted odds ratio with 95% CI for MASLD and liver fibrosis according to eGDR 7.0 mg/kg/min. The number of knots for the cubic spline curves was three in the model. Adjustment factors included age, gender, race, marital status, education, PIR, fasting glucose, ALT, AST, eGFR, HDL-C, UA, diabetes mellitus, dyslipidemia, moderate PA, and smoking status Abbreviations: 95% CI: 95% confidence interval; OR: odds ratio; MASLD: metabolic dysfunction-associated steatotic liver disease; eGDR: estimated glucose disposal rate; eGFR: estimated glomerular filtration rate; PIR: Ratio of family income to poverty; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; HDL-C: High-density lipoprotein cholesterol; UA: Uric acid; PA: Physical activity
Fig. 4
Fig. 4
The association between eGDR and MASLD (A) and liver fibrosis (B) in various subgroups. The results are adjusted for age, gender, eGFR, PIR, marital status, diabetes mellitus, dyslipidemia, smoking status, and moderate PA, if the above variables are not adjusted Abbreviations: 95% CI: 95% confidence interval; OR: odds ratio; MASLD: metabolic dysfunction-associated steatotic liver disease; eGDR: estimated glucose disposal rate; PIR: Ratio of family income to poverty; eGFR: estimated glomerular filtration rate; PA: Physical activity
Fig. 5
Fig. 5
Receiver operative characteristic (ROC) curves and corresponding areas under the curve (AUC) Abbreviations: eGDR: estimated glucose disposal rate; MASLD: metabolic dysfunction-associated steatotic liver disease
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