Frontiers in Nutrition
How is estimated glucose disposal rate associated with prevalent hyperuricemia and self-reported gout in NHANES adults after survey weighting and measured-covariate adjustment?
The study analyzed adults from six NHANES cycles covering 2007–2018. The exposure eGDR combines waist circumference, hypertension and HbA1c; hyperuricemia was defined from serum uric acid using sex-specific thresholds, while gout relied on self-reported professional diagnosis. In Model 3, each 1 mg/kg/min higher eGDR was associated with lower odds of both outcomes. For gout, the 4–6 mg/kg/min category did not differ significantly from the <4 reference after full adjustment. This exception is explicit in the body and Table 3 and prevents adopting the abstract's universal category-significance claim. The analysis concerns prevalent disease, with residual confounding, self-report and temporal-order limitations.
Pengfei Liu, Kaisaierjiang Kadier, Xiaoli Wu, Xiangyu Sun, Ge Zhang, Xiaozhu Liu, Daqing Song, Chunying Cui. Association between higher estimated glucose disposal rate and reduced prevalence of hyperuricemia and gout. Frontiers in Nutrition. 2025. https://doi.org/10.3389/fnut.2025.1658286
Estimated glucose disposal rate, hyperuricemia and gout: cross-sectional NHANES associations
A survey-weighted analysis of 29,340 NHANES participants examined eGDR associations with hyperuricemia and self-reported gout. Fully adjusted continuous associations were inverse, but the 4–6 mg/kg/min gout contrast was not statistically significant. The evidence does not establish prevention or a treatment effect.
Participant counts are unweighted observations, not weighted prevalence estimates or incident cases.
| Measure | Value |
|---|---|
| analytic participants | 29,340 |
| NHANES cycles | 6 (2007–2018) |
| hyperuricemia cases | 5,433 |
| self-reported gout cases | 1,346 |
Source locator: Methods §2.1 Study design and population (sec7); §2.3 Diagnosis of HUA and gout (sec9); Tables 2 and 3 (tab2, tab3), Continuous case/participants rows
Model 3 weighted logistic regression; odds per 1 mg/kg/min higher eGDR. This is not a 17% reduction in incidence or an intervention effect.
| Measure | Value |
|---|---|
| Model 3 odds ratio | 0.83 |
| 95% confidence interval | 0.81–0.85 |
| P value | <0.001 |
Source locator: Methods §2.2 Calculation of eGDR (sec8), §2.5 Statistical analyses (sec11); Results §3.2 (sec14); Table 2 (tab2), Continuous row, Model 3 and covariate footnote
Table 3 Model 3 compares eGDR categories with <4 mg/kg/min. The 4–6 comparison includes the null and is explicitly described as nonsignificant in Results §3.3.
| Measure | Value |
|---|---|
| continuous OR per 1 mg/kg/min | 0.83 (95% CI 0.79–0.87), P<0.001 |
| 4–6 mg/kg/min versus <4 | OR 0.81 (95% CI 0.63–1.04), P=0.093 |
| 6–8 mg/kg/min versus <4 | OR 0.62 (95% CI 0.47–0.82), P=0.001 |
| >8 mg/kg/min versus <4 | OR 0.35 (95% CI 0.25–0.48), P<0.001 |
Source locator: Results §3.3 Association between eGDR and gout (sec15); Table 3 (tab3), Continuous and category rows, Model 3; contrast with Abstract Results category statement
The eGDR proxy and observational outcome definitions do not directly measure a treatment response or establish a new clinical diagnostic test.
| Measure | Value |
|---|---|
| eGDR equation (mg/kg/min) | 21.158 − 0.09×waist circumference (cm) − 3.407×hypertension (yes=1/no=0) − 0.551×HbA1c (%) |
| hyperuricemia thresholds | >7.0 mg/dL in males; >6.0 mg/dL in females |
| gout ascertainment | Self-reported professional diagnosis |
Source locator: Methods §2.2 Calculation of eGDR (sec8); §2.3 Diagnosis of HUA and gout (sec9)
| Cohort | Role | n | Relationship |
|---|---|---|---|
| NHANES 2007–2018 analytic sample | Single cross-sectional survey sample used for both outcome analyses; not two independent cohorts | 29,340 | Independent cohort |
The weighted Model 3 association in this NHANES sample is OR 0.83 per 1 mg/kg/min, with CI 0.81–0.85; this is not incidence reduction.
No. The 4–6 versus <4 contrast is nonsignificant in fully adjusted Model 3; continuous and higher-category associations require their own stated contrasts.
Evidence: KF3
eGDR was calculated from waist circumference, hypertension and HbA1c; gout was self-reported professional diagnosis.
Evidence: KF4
| Row ID | Component | Context | Finding | Evidence Level | Scope | Source Locator | Evidence refs |
|---|---|---|---|---|---|---|---|
| evidence-kf1 | Both outcome analyses use the same selected cross-sectional NHANES sample. | Participant counts are unweighted observations, not weighted prevalence estimates or incident cases. | analytic participants: 29,340; NHANES cycles: 6 (2007–2018); hyperuricemia cases: 5,433; self-reported gout cases: 1,346 | Survey-weighted cross-sectional observational analysis | Reported prevalence-odds association or study measurement, not incident disease prediction or an intervention effect. | Methods §2.1 Study design and population (sec7); §2.3 Diagnosis of HUA and gout (sec9); Tables 2 and 3 (tab2, tab3), Continuous case/participants rows | KF1 |
| evidence-kf2 | Higher continuous eGDR was associated with lower adjusted odds of hyperuricemia. | Model 3 weighted logistic regression; odds per 1 mg/kg/min higher eGDR. This is not a 17% reduction in incidence or an intervention effect. | Model 3 odds ratio: 0.83; 95% confidence interval: 0.81–0.85; P value: <0.001 | Survey-weighted cross-sectional observational analysis | Reported prevalence-odds association or study measurement, not incident disease prediction or an intervention effect. | Methods §2.2 Calculation of eGDR (sec8), §2.5 Statistical analyses (sec11); Results §3.2 (sec14); Table 2 (tab2), Continuous row, Model 3 and covariate footnote | KF2 |
| evidence-kf3 | The continuous gout association was inverse, but not every categorical contrast was statistically significant after full adjustment. | Table 3 Model 3 compares eGDR categories with <4 mg/kg/min. The 4–6 comparison includes the null and is explicitly described as nonsignificant in Results §3.3. | continuous OR per 1 mg/kg/min: 0.83 (95% CI 0.79–0.87), P<0.001; 4–6 mg/kg/min versus <4: OR 0.81 (95% CI 0.63–1.04), P=0.093; 6–8 mg/kg/min versus <4: OR 0.62 (95% CI 0.47–0.82), P=0.001; >8 mg/kg/min versus <4: OR 0.35 (95% CI 0.25–0.48), P<0.001 | Survey-weighted cross-sectional observational analysis | Reported prevalence-odds association or study measurement, not incident disease prediction or an intervention effect. | Results §3.3 Association between eGDR and gout (sec15); Table 3 (tab3), Continuous and category rows, Model 3; contrast with Abstract Results category statement | KF3 |
| evidence-kf4 | The exposure and outcomes were estimated or measured using distinct operational definitions. | The eGDR proxy and observational outcome definitions do not directly measure a treatment response or establish a new clinical diagnostic test. | eGDR equation (mg/kg/min): 21.158 − 0.09×waist circumference (cm) − 3.407×hypertension (yes=1/no=0) − 0.551×HbA1c (%); hyperuricemia thresholds: >7.0 mg/dL in males; >6.0 mg/dL in females; gout ascertainment: Self-reported professional diagnosis | Survey-weighted cross-sectional observational analysis | Reported prevalence-odds association or study measurement, not incident disease prediction or an intervention effect. | Methods §2.2 Calculation of eGDR (sec8); §2.3 Diagnosis of HUA and gout (sec9) | KF4 |
One analytic sample of 29,340 adults was used for both outcomes; Tables 2 and 3 list 5,433 hyperuricemia and 1,346 self-reported gout cases. These case counts must not be substituted for survey-weighted prevalence.
Evidence: KF1
No. Table 3 Model 3 gives OR 0.81, 95% CI 0.63–1.04 and P=0.093 for 4–6 versus <4 mg/kg/min. Results §3.3 states this loss of significance. The abstract's broader all-category statement is not adopted.
Evidence: KF3
Per 1 mg/kg/min higher eGDR, Model 3 reports OR 0.83 (95% CI 0.81–0.85) for hyperuricemia and OR 0.83 (0.79–0.87) for gout. These are prevalence-odds associations.
Evidence: KF2, KF3
No. The cross-sectional design cannot establish temporal order or a preventive intervention effect. Gout is self-reported and eGDR is a calculated proxy.
Evidence: KF1, KF4
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