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February 8, 2026Brain and Behavior0 citationsOpen Access

Cardiometabolic Index as a Mediator in the Association Between Estimated Glucose Disposal Rate and Depressive Symptoms: A Population‐Based Study

MLMimi LiSWSheng-Ze WuXYXiaofang Ye

Key Result

Higher eGDR (≥9.44 mg/kg/min) was associated with 32% lower odds of depressive symptoms compared to lowest tertile, with CMI mediating 11.2% of this effect.

Key Points

  • The aim is to investigate the link between estimated glucose disposal rate (eGDR) and depressive symptoms, focusing on the role of cardiometabolic index (CMI) as a mediator.
  • Cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES)
  • Examination of relationships using weighted logistic regression and receiver operating characteristic (ROC) analysis
  • Application of mediation analysis to explore CMI's role in the eGDR-depression relationship
  • Higher eGDR is associated with a lower likelihood of depressive symptoms, with an odds ratio of 0.68 for the highest eGDR group compared to the lowest.
  • CMI mediates approximately 11.2% of the relationship between eGDR and depressive symptoms.
  • eGDR shows better predictive capacity for depressive symptoms compared to other indices like TyG and HOMA-IR.

Structured PICO

Is higher estimated glucose disposal rate associated with a lower likelihood of depressive symptoms in the general population?

P
Population
12,191 individuals from the National Health and Nutrition Examination Survey (NHANES)
I
Intervention
Higher estimated glucose disposal rate (eGDR) (Tertile 3: ≥9.44 mg/kg/min)
C
Comparator
Lower estimated glucose disposal rate (eGDR) (Tertile 1: <6.15 mg/kg/min)
O
Outcome
Depressive symptomspatient reported

Higher estimated glucose disposal rate, a marker of lower insulin resistance, is associated with reduced odds of depressive symptoms, an effect partially mediated by the cardiometabolic index.

Abstract

ABSTRACT Background Estimated glucose disposal rate (eGDR) emerged as an innovative marker for insulin resistance, and this study was designed to investigate the connection between eGDR and depressive symptoms. Methods Information from the National Health and Nutrition Examination Survey (NHANES) was processed within the cross‐sectional research. Relationships between depressive symptoms and eGDR were examined using weighted logistic regression models, restricted cubic splines (RCS), sensitivity analyses, and subgroup comparisons. Receiver operating characteristic (ROC) curve analysis assessed the capacity for prediction of eGDR, relative to triglyceride‐glucose (TyG) index, Homeostasis Model Assessment of Insulin Resistance (HOMA‐IR), and glycated hemoglobin (HbA1c). Mediation analysis was also applied to assess cardiometabolic index (CMI)’s potential role in the eGDR‐depression relationship. Results: This analysis comprised 12,191 individuals stratified by eGDR tertiles (T1: <6.15; T2: 6.15–9.44; T3: ≥9.44 mg/kg/min). Multivariate logistic regression, adjusted for covariates, found that T3 had a significantly lower odds ratio for depressive symptoms than T1 (OR = 0.68, 95% CI: 0.48–0.97). RCS curves confirmed a linear trend (P for non‐linearity = 0.764). The negative association was particularly evident in participants under 60, non‐Hispanic Black individuals, those living alone, and those without cardiovascular disease. ROC analysis indicated that eGDR had better discriminative power for depressive symptoms than TyG, HOMA‐IR, and HbA1c ( p < 0.05). Additionally, CMI mediated approximately 11.2% (95% CI: 4.2%–32.7%) of the total effect of eGDR on depressive symptoms. Conclusions Higher eGDR correlates with lower likelihood of depressive symptoms, with CMI acting as a mediator. Reducing insulin resistance and monitoring CMI could help decrease the occurrence of depression.

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Cite This Study

Li et al. (2026) studied this question. Higher eGDR (≥9.44 mg/kg/min) was associated with 32% lower odds of depressive symptoms compared to lowest tertile, with CMI mediating 11.2% of this effect.

synapsesocial.com/papers/698828410fc35cd7a88478a8https://doi.org/10.1002/brb3.71247
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