Prospective cohort study of the association of estimated glucose disposal rate with GI cancer mortality in the UK Biobank

The estimated glucose disposal rate (eGDR) is a surrogate of insulin sensitivity, and the triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C) and the triglyceride-glucose (TyG) are indices for insulin resistance. A prospective cohort study using data from the UK Biobank examined the associations of eGDR with gastrointestinal (GI) cancer mortality. The study included 369,447 participants without cancer at baseline. During a mean follow-up of 13.5 years, 4305 GI cancer-related deaths were reported. Higher eGDR was associated with lower pooled GI cancer mortality (sHR 0.67; p<0.001). Associations with esophageal cancer, esophageal squamous cell carcinoma, colorectal cancer, liver cancer, and pancreatic cancer mortality remained significant after false discovery rate correction. TyG, but not TG/HDL-C remained associated with pooled GI cancer mortality. The authors conclude that higher eGDR was associated with lower pooled and several site-specific cancer mortality outcomes, whereas TG/HDL-C, and TyG associations were modest and site-specific.