Association of eGDR with kidney stones, weighted.

BackgroundKidney stone formation has been linked to insulin resistance (IR). However, the association between the estimated glucose disposal rate (eGDR) – a novel surrogate marker for IR – and kidney stone occurrence in non-diabetic adults remains unclear.MethodsWe analyzed data from adult participants in the National Health and Nutrition Examination Survey (NHANES) collected between 2009 and 2020 who self-reported a history of kidney stones. To assess the relationship between eGDR and kidney stones, we applied a range of statistical methods, including weighted proportions, multivariable logistic regression, restricted cubic splines (RCS), receiver operating characteristic (ROC) curve analysis, subgroup analysis, and mediation analysis.ResultsThe final analysis included 8,051 participants, of whom 8.71% reported a history of kidney stones. Multivariable logistic regression revealed that, compared to the lowest eGDR quartile, the fully adjusted odds ratios (95% confidence intervals) for kidney stone in the second, third, and fourth quartiles were 0.87 (0.61–1.26), 0.54 (0.34–0.85), and 0.46 (0.28–0.77), respectively. The RCS plot indicated a significant non-linear inverse association between eGDR and kidney stone risk. ROC curve analysis showed that the association between eGDR and the risk of kidney stones was more pronounced compared to the other five IR indicators, as evidenced by a higher area under the curve. Mediation analysis identified albumin (ALB) and red cell distribution width (RDW) as partial mediators in the association between IR and kidney stones.ConclusionOur research results indicate that lower levels of eGDR are associated with an increased risk of developing kidney stones in non-diabetic adults. Furthermore, ALB and RDW may partially mediate the relationship between IR and kidney stones.研究背景：肾结石形成与胰岛素抵抗（insulin resistance, IR）密切相关。然而，作为IR新型替代标志物的估算葡萄糖处置率（estimated glucose disposal rate, eGDR）与非糖尿病成年人肾结石发病之间的关联仍不明确。 研究方法：本研究分析了2009年至2020年国家健康与营养检查调查（National Health and Nutrition Examination Survey, NHANES）中成年参与者的数据，这些参与者均自述有肾结石病史。为评估eGDR与肾结石之间的关联，本研究采用了多种统计方法，包括加权构成比、多变量logistic回归、限制性立方样条（restricted cubic splines, RCS）、受试者工作特征（receiver operating characteristic, ROC）曲线分析、亚组分析及中介分析。 研究结果：最终分析共纳入8051名参与者，其中8.71%的参与者自述有肾结石病史。多变量logistic回归结果显示，与eGDR最低四分位数组相比，第二、第三、第四四分位数组的肾结石完全校正比值比（95%置信区间）分别为0.87（0.61~1.26）、0.54（0.34~0.85）及0.46（0.28~0.77）。限制性立方样条图显示，eGDR与肾结石风险之间存在显著的非线性负相关关系。受试者工作特征曲线分析表明，与其他5项IR指标相比，eGDR与肾结石风险的关联更为显著，这一点可通过更高的曲线下面积得以证实。中介分析显示，白蛋白（albumin, ALB）与红细胞分布宽度（red cell distribution width, RDW）是IR与肾结石关联的部分中介因子。 研究结论：本研究结果表明，在非糖尿病成年人中，较低的eGDR水平与肾结石发病风险升高显著相关。此外，ALB和RDW可能部分介导IR与肾结石之间的关联。