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April 5, 2026BMC Endocrine DisordersOpen Access

A practical tool for risk stratification: eGDR as a predictor of incident diabetic kidney disease

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Key result

Higher eGDR linked to ~14% lower 5-year risk of incident diabetic kidney disease in type 2 diabetes.

  • OR 0.86
  • 95% CI 0.76-0.97
  • P=0.016
  • n=451

Why the study?

Most insulin resistance measures are impractical in daily care, so this study evaluated whether the estimated glucose disposal rate (eGDR) predicts 5-year DKD risk.

Does a lower estimated glucose disposal rate (eGDR) predict incident diabetic kidney disease in adults with type 2 diabetes?

Population

Adults with type 2 diabetes and no DKD at baseline

Comparison

Lower vs higher eGDR levels

Design

Cohort study

Follow-up

5 years

Authors

YLYuanxin LiuBeijing Institute of TechnologyDLDongmei LiuNanjing Medical UniversityMLMingda LiuNanjing Agricultural University

Discussion

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Implication

May improve DKD risk stratification in T2D via eGDR; extends evidence linking insulin resistance to renal complications.

Key Points

  • This research aims to evaluate the relationship between estimated glucose disposal rate (eGDR) and the 5-year risk of developing diabetic kidney disease (DKD) in adults with type 2 diabetes.
  • Analyzed data from adults with type 2 diabetes without DKD at baseline over five years.
  • Calculated eGDR using waist circumference, HbA1c, and hypertension status.
  • Defined DKD by new albuminuria or a decrease in eGFR below 60 mL/min/1.73 m².
  • Used logistic regression to examine the association between eGDR and DKD risk.
  • Assessed model accuracy using discrimination, calibration, and decision-curve analysis.
  • 27.1% of participants developed DKD during the 5-year follow-up.
  • Lower eGDR values correlated with a higher risk of DKD (adjusted OR = 0.86, p = 0.016).
  • Participants in the highest eGDR group had half the risk of DKD compared to the lowest group (OR = 0.47, p = 0.017).
  • The combined model of eGDR and age had a C-index of 0.659, indicating moderate predictive ability.
  • Decision-curve analysis showed clinical benefit when the predicted DKD risk ranged from 0.10 to 0.35.

Study Design

Type

Cohort (n=451)

Multicenter

No

Structured PICO

Does a lower estimated glucose disposal rate (eGDR) predict incident diabetic kidney disease in adults with type 2 diabetes?

P
Population
451 adults with type 2 diabetes without baseline diabetic kidney disease (eGFR ≥60 mL/min/1.73 m² and UACR <30 mg/g), followed for 5 years. Excluded patients on SGLT2 inhibitors or GLP-1 receptor agonists.
I
Intervention
Estimated glucose disposal rate (eGDR) assessment (calculated from waist circumference, HbA1c, and hypertension status)
C
Comparator
Lower vs higher eGDR values (analyzed continuously and by tertiles)
O
Outcome
Incident diabetic kidney disease (DKD) during 5-year follow-up, defined as eGFR <60 mL/min/1.73 m² and/or UACR ≥30 mg/g at the 5-year visitcomposite

Main Result

Effect estimate: OR 0.86 (95% CI 0.76-0.97)

p-value: p=0.016

A lower estimated glucose disposal rate (eGDR) is an independent predictor of 5-year incident diabetic kidney disease in patients with type 2 diabetes, and combining eGDR with age provides a useful risk stratification tool.

Limitations

  • Intermediate follow-up laboratory data were not uniformly available, meaning persistent abnormalities over ≥3 months were not systematically confirmed.
  • Retrospective single-center study design.
  • Intermediate follow-up laboratory data were not uniformly available
  • Persistent abnormalities over ≥3 months were not systematically confirmed
  • Retrospective study design

Cite This Study

Liu et al. (2026) conducted a cohort in Type 2 diabetes (n=451). Estimated glucose disposal rate (eGDR) vs. Higher eGDR was evaluated on Incident diabetic kidney disease (eGFR <60 mL/min/1.73 m² and/or UACR ≥30 mg/g at 5 years) (OR 0.86, 95% CI 0.76-0.97, p=0.016). Lower estimated glucose disposal rate (eGDR) was independently associated with a higher 5-year risk of incident diabetic kidney disease in patients with type 2 diabetes (adjusted OR 0.86).

synapsesocial.com/papers/69d1fc4fa79560c99a0a1e74https://doi.org/10.1186/s12902-026-02229-7
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Diabetes and Renal Complications: An Overview on Pathophysiology, Biomarkers and Therapeutic Interventions2024 · 137 citations
  2. 2Association of estimated glucose disposal rate with chronic kidney disease: comparative analysis against traditional insulin resistance indices2025 · 6 citations
  3. 3Combined effects of insulin resistance and dyslipidaemia on cardiometabolic multimorbidity in Chinese middle-age and older adults: a longitudinal cohort study2025 · 5 citations
  4. 4Lifestyle-Related Risk Factors for the Incidence and Progression of Chronic Kidney Disease in the Healthy Young and Middle-Aged Population2022 · 57 citations
  5. 5Role and Treatment of Insulin Resistance in Patients with Chronic Kidney Disease: A Review2021 · 79 citations