Association of Estimated Glucose Disposal Rate and Risk of Lung Cancer: A Cross-sectional Study

Background : Insulin resistance (IR) is implicated in oncogenesis. The estimated glucose disposal rate (eGDR), a novel non-insulin-based marker, demonstrates high accuracy in assessing IR. This study aimed to investigate the association between eGDR and lung cancer risk. Methods : Ten cycles (1999–2018) from the National Health and Nutrition Examination Survey (NHANES) database, which included self-reported or administrative lung-cancer diagnoses, were analyzed. Among the 101,316 participants initially extracted, the following were excluded: those without a lung cancer diagnosis (N = 51,862), those without a hypertension diagnosis (N = 234), and those missing eGDR data (N = 6,771). The final study included 42,449 participants, comprising 92 patients with lung cancer and 42,357 patients with normal samples. A 1:1 Propensity Score Matching (PSM) method was used to match participants based on sex, race, and education. Following the PSM analysis, both study populations were analyzed to ensure the robustness and accuracy of the results. Weighted binary logistic regression was used to analyze the potential association between eGDR and lung cancer disease. Results: The results showed a statistically significant difference (P-value < 0.001) in eGDR between the lung cancer (6.91 ± 2.16) and control groups (8.12 ± 3.01) after matching for sex, race, and education. After further adjusting for other factors, the odds ratio (OR) of lung cancer for eGDR was 0.812 (95% CI: 0.697–0.939, P = 0.0058), indicating that eGDR serves as a protective factor against lung cancer. In the quartile analysis of eGDR, a significant decreasing trend was observed (Q4 vs. Q1, OR: 0.109, 95% CI: 0.031–0.347, P-value < 0.001). The restrictive cubic splines showed that a gradual decrease in lung cancer prevalence was associated with an elevated eGDR. Sensitivity analysis revealed that effect sizes and directions were consistent across subgroups, and the results remained stable. Conclusion: A gradual decrease in lung cancer prevalence is associated with an increase in eGDR.