肾结石患者估算葡萄糖处置率与心血管疾病死亡、全因死亡的关联性研究OA

Objective To investigate the association between the estimated glucose disposal rate(eGDR)and mortality in patients with kidney stones,which holds significant importance for prognostic monitoring.Methods Utilizing data from the National Health and Nutrition Examination Survey(NHANES),a multivariate Cox regression model combined with restricted cubic spline analysis was employed to explore the associations between eGDR and both cardiovascular disease mortality and all-cause mortality in kidney stone patients.Subgroup and stratified analyses were conducted,alongside an assessment of mediation effects.Results During a median follow-up of 6.25 a(75 months),351 all-cause death events and 79 cardiovascular-specific death events occurred.The multivariate-adjusted Cox proportional hazards model showed that each 1-unit increase in eGDR was associated with a 10%reduction in all-cause mortality risk(HR 0.90,95%CI 0.84-0.96)and a 17%reduction in cardiovascular mortality risk(HR 0.83,95%CI 0.74-0.94).Mediation analysis indicated that the estimated Glomerular Filtration Rate(eGFR)accounted for 36.4%of the association between eGDR and all-cause mortality and for 40%of its association with cardiovascular disease mortality,suggesting a partial mediation effect.Conclusions The findings demonstrate that reduced eGDR is linked to higher all-cause and cardiovascular mortality risks in U.S.adult kidney stone patients,offering a new theoretical perspective for their integrated management and prognosis assessment.