Association between Estimated Glucose Disposal Rate and Sarcopenia in US Adults: A Cross-Sectional Study Based on NHANES 2011–2018

Association between Estimated Glucose Disposal Rate and Sarcopenia in US Adults: A Cross-Sectional Study Based on NHANES 2011–2018 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Association between Estimated Glucose Disposal Rate and Sarcopenia in US Adults: A Cross-Sectional Study Based on NHANES 2011–2018 Qian Xiao, Hongyan He, Xiaoqian Hu, Yuechi Luo, Yongxin Wu, Yuan Gao, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8179768/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background Sarcopenia is an age-related disorder that severely impacts the quality of life and health of older adults, primarily characterized by accelerated loss of muscle mass and strength. Insulin resistance represents a key pathophysiological mechanism underlying sarcopenia. The estimated glucose disposal rate (eGDR) is a novel indicator of insulin resistance that reflects the body's ability to process glucose. It is unclear about the association between eGDR and sarcopenia in adults. This research investigates the relationship between eGDR and sarcopenia to support improved clinical identification of the condition. Methods This research analyzed data from the 2011–2018 National Health and Nutrition Examination Survey (NHANES), which included 7,147 participants. eGDR was determined based on the following formula: eGDR (mg/kg/min) = 21.158 − (0.09 × WC) − (3.407 × hypertension) − (0.551 × HbA1c), [WC (cm), hypertension (yes = 1/no = 0), and HbA1c (%)]. Based on eGDR values, participants were sorted into quartiles. The connection between eGDR and sarcopenia risk was analyzed through multivariable logistic regression models. Dose-response association were analyzed via the restricted cubic spline (RCS) curves. Subgroup analyses and interaction tests were conducted to assess the robustness of the association. Mediation analysis was used to assess the mediating role of inflammation in the relation between eGDR and sarcopenia. Results Multivariable logistic regression revealed an obvious inverse association between eGDR and sarcopenia. In the fully adjusted model, compared with the lowest eGDR quartile group, the adjusted odds ratios (95% confidence intervals) for sarcopenia in quartiles 2 to 4 were 0.48 (95% CI: 0.32, 0.71; p < 0.001), 0.22 (95% CI: 0.13, 0.37; p < 0.001), and 0.07 (95% CI: 0.04, 0.13; p < 0.001), respectively. The results of subgroup analyses and interaction tests indicate that this relation is not affected by factors such as age, gender, race, marital status, education, smoking, or drinking. Mediation analysis confirmed the mediating roles of inflammatory indexes in the association between eGDR and sarcopenia (p < 0.001). Conclusion A negative relation was observed between eGDR and the prevalence of sarcopenia. Inflammatory response may mediate this relationship. eGDR may serve as a potential biomarker for the early identification and diagnosis of sarcopenia. Sarcopenia Estimated Glucose Disposal Rate (eGDR) Insulin Resistance Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 22 Mar, 2026 Reviews received at journal 22 Mar, 2026 Reviews received at journal 19 Mar, 2026 Reviewers agreed at journal 18 Mar, 2026 Reviewers agreed at journal 05 Mar, 2026 Reviewers invited by journal 02 Dec, 2025 Editor assigned by journal 25 Nov, 2025 Submission checks completed at journal 25 Nov, 2025 First submitted to journal 22 Nov, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8179768","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":554393921,"identity":"1596b94d-50fc-449b-a922-48957d715af5","order_by":0,"name":"Qian 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2011–2018","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"diabetology-and-metabolic-syndrome","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"dims","sideBox":"Learn more about [Diabetology \u0026 Metabolic Syndrome](http://dmsjournal.biomedcentral.com/)","snPcode":"13098","submissionUrl":"https://submission.nature.com/new-submission/13098/3","title":"Diabetology \u0026 Metabolic Syndrome","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Sarcopenia, Estimated Glucose Disposal Rate (eGDR), Insulin Resistance","lastPublishedDoi":"10.21203/rs.3.rs-8179768/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8179768/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eSarcopenia is an age-related disorder that severely impacts the quality of life and health of older adults, primarily characterized by accelerated loss of muscle mass and strength. Insulin resistance represents a key pathophysiological mechanism underlying sarcopenia. The estimated glucose disposal rate (eGDR) is a novel indicator of insulin resistance that reflects the body's ability to process glucose. It is unclear about the association between eGDR and sarcopenia in adults. This research investigates the relationship between eGDR and sarcopenia to support improved clinical identification of the condition.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eThis research analyzed data from the 2011\u0026ndash;2018 National Health and Nutrition Examination Survey (NHANES), which included 7,147 participants. eGDR was determined based on the following formula: eGDR (mg/kg/min)\u0026thinsp;=\u0026thinsp;21.158 \u0026minus; (0.09 \u0026times; WC) \u0026minus; (3.407 \u0026times; hypertension) \u0026minus; (0.551 \u0026times; HbA1c), [WC (cm), hypertension (yes\u0026thinsp;=\u0026thinsp;1/no\u0026thinsp;=\u0026thinsp;0), and HbA1c (%)]. Based on eGDR values, participants were sorted into quartiles. The connection between eGDR and sarcopenia risk was analyzed through multivariable logistic regression models. Dose-response association were analyzed via the restricted cubic spline (RCS) curves. Subgroup analyses and interaction tests were conducted to assess the robustness of the association. Mediation analysis was used to assess the mediating role of inflammation in the relation between eGDR and sarcopenia.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eMultivariable logistic regression revealed an obvious inverse association between eGDR and sarcopenia. In the fully adjusted model, compared with the lowest eGDR quartile group, the adjusted odds ratios (95% confidence intervals) for sarcopenia in quartiles 2 to 4 were 0.48 (95% CI: 0.32, 0.71; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), 0.22 (95% CI: 0.13, 0.37; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and 0.07 (95% CI: 0.04, 0.13; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), respectively. The results of subgroup analyses and interaction tests indicate that this relation is not affected by factors such as age, gender, race, marital status, education, smoking, or drinking. Mediation analysis confirmed the mediating roles of inflammatory indexes in the association between eGDR and sarcopenia (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eA negative relation was observed between eGDR and the prevalence of sarcopenia. Inflammatory response may mediate this relationship. eGDR may serve as a potential biomarker for the early identification and diagnosis of sarcopenia.\u003c/p\u003e","manuscriptTitle":"Association between Estimated Glucose Disposal Rate and Sarcopenia in US Adults: A Cross-Sectional Study Based on NHANES 2011–2018","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-05 16:28:40","doi":"10.21203/rs.3.rs-8179768/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-22T13:00:22+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-22T07:02:59+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-19T06:35:05+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"155440837889797825007010319576311937926","date":"2026-03-19T02:31:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"211882403768411733267869818331577896837","date":"2026-03-05T23:52:34+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-03T03:19:16+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-25T09:11:12+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-25T09:08:45+00:00","index":"","fulltext":""},{"type":"submitted","content":"Diabetology \u0026 Metabolic Syndrome","date":"2025-11-22T10:23:53+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"diabetology-and-metabolic-syndrome","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"dims","sideBox":"Learn more about [Diabetology \u0026 Metabolic Syndrome](http://dmsjournal.biomedcentral.com/)","snPcode":"13098","submissionUrl":"https://submission.nature.com/new-submission/13098/3","title":"Diabetology \u0026 Metabolic Syndrome","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b797eada-9717-4a5b-9c1e-4a53f58a2c46","owner":[],"postedDate":"December 5th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-29T17:54:09+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-05 16:28:40","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8179768","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8179768","identity":"rs-8179768","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}