Association between eGDR and the risk of chest pain: A comparative analysis based on NHANES and CHARLS databases

Insulin resistance is closely associated with various cardiovascular and metabolic diseases. The estimated glucose disposal rate (eGDR), as a convenient assessment indicator of insulin resistance, has been increasingly utilized in recent years for cardiovascular risk prediction. However, studies on the relationship between eGDR and chest pain risk remain relatively scarce. Based on the 2 major databases of National Health and Nutrition Examination Survey (NHANES) and China Health and Retirement Longitudinal Study (CHARLS), this study systematically analyzed the association between eGDR levels and the risk of chest pain and compared the similarities and differences in the results between the 2 populations. We utilized databases from 2 prospective cohorts, NHANES and CHARLS. The eGDR calculation formula was: eGDR = 21.158 - (0.09 × WC) - (3.407 × HTN) - (0.551 × HbA1c). Here, WC represents waist circumference (cm), HTN indicates a history of hypertension (yes = 1, no = 0), and HbA1c denotes glycated hemoglobin (%). Participants were stratified according to eGDR levels into quartiles. A multivariate logistic regression model was employed to assess the association between eGDR and chest pain, with dose-response curves analyzed using restricted cubic spline analysis. In the fully adjusted model, the highest quartile of eGDR in CHARLS showed a trend of reduced risk for chest pain compared to the lowest quartile (odds ratio = 0.86, 95% confidence interval: 0.73-1.01, P = .066), whereas a significant negative correlation was observed in NHANES (odds ratio = 0.54, 95% confidence interval: 0.45-0.65, P < .001). Elevated eGDR (reduced insulin resistance) was significantly associated with a decreased risk of chest pain, suggesting that insulin resistance may be an important potential risk factor for chest pain. This association was consistent in both China and the United States, though the magnitude of the effect varied. This study supports the use of eGDR as a potential biomarker for identifying chest pain risk.