Correlation of the estimated glucose disposal rate with self-reported endometrial cancer: a cross-sectional study from NHANES 1999–2018

Objective Given accumulating data implicating insulin resistance (IR) in endometrial carcinogenesis, this study evaluated whether eGDR—a feasible non-invasive IR metric—is associated with self-reported endometrial cancer in a cross-sectional population-based sample.Methods The analytical sample consisted of 31,666 female NHANES respondents (1999-2018), including 248 EC cases versus 31,418 cancer-free comparators. Propensity score matching (1:1) controlled for baseline imbalances.Results The eGDR was significantly lower in the EC group (6.84 ± 2.76) than in the control group (7.51 ± 2.66) (P = 0.004). After adjusting for confounding variables, the odds ratio (OR) for eGDR as a inversely associated with self-reported EC was 0.906 (95% CI: 0.826–0.991, P = 0.0328). A significant decreasing trend in EC risk was observed across eGDR quartiles. After covariate adjustment, eGDR remained inversely associated with EC (Model 2: OR 0.917, 95% CI 0.849–0.988, P = 0.024; Model 3: OR 0.906, 95% CI 0.826–0.991, P = 0.0328). Additionally, the restricted cubic spline revealed a significant nonlinear correlation between eGDR and the risk of EC.Conclusions In this large cross-sectional study, higher eGDR was associated with lower odds of prevalent self-reported EC. These findings suggest a link between insulin sensitivity and endometrial cancer that warrants prospective evaluation.