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ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1540794
This article is part of the Research Topic Re-visiting Risk Factors for Cardiometabolic Diseases: Towards a New Epidemiological Frontier View all 22 articles
Estimated glucose disposal rate (eGDR) mediates the association between Life's Crucial 9 (LC9) and congestive heart failure (CHF): A population-based study
Provisionally accepted- 1 The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China
- 2 Henan Provincial People's Hospital, Zhengzhou, Henan Province, China
Life's Crucial 9 (LC9) is the latest indicator of cardiovascular health (CVH), and the estimated glucose disposal rate (eGDR) is a non-invasive indicator of insulin resistance (IR). However, the relationships between LC9 and eGDR and congestive heart failure (CHF) remain unknown.In this cross-sectional study, participants aged ≥20 years in the NHANES database from 2005 to 2018 were analyzed. Weighted linear regression, logistic regression, subgroup analysis, and restricted cubic spline (RCS) analysis were employed to analyze the associations among LC9, eGDR, and CHF. Mediation analysis was used to explore the mediating role of eGDR in the association between LC9 and CHF.A total of 22,699 adult participants were included, among whom 661 suffered from CHF. The mean age of the participants was 47.52 (0.26) years old, with 11186 (48.68%) males and 11513 (51.32%) females. The average value of LC9 was 71.16 (0.22), and that of eGDR was 7.91 (0.04). After adjusting for confounding factors, linear regression showed that LC9 was independently and positively associated with eGDR (β: 1.11, 95%CI: 1.07 -1.14, P < 0.0001). Logistic regression indicated that both LC9 (OR: 0.76, 95%CI: 0.65 -0.88, P < 0.001) and eGDR (OR: 0.81, 95%CI: 0.76 -0.86, P < 0.0001) were independently and negatively associated with the prevalence of CHF. Mediation analysis revealed that the association between LC9 and CHF was mainly mediated by eGDR, with a proportion of 66%.This study suggests that higher LC9 scores and eGDR values imply a lower prevalence of CHF. Meanwhile, eGDR is the main intermediate factor in the association between LC9 and CHF, indicating that good CVH may reduce the prevalence of CHF by improving IR.
Keywords: Life's Crucial 9 (LC9), estimated glucose disposal rate (eGDR), Congestive Heart Failure (CHF), NHANES, Cross-sectional study, Mediation analysis
Received: 06 Dec 2024; Accepted: 04 Mar 2025.
Copyright: © 2025 Wang, Xu, Chen and Zhang. 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:
Huifeng Zhang, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China
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