Medicine · Nov 6, 2026

Joint associations of estimated glucose disposal rate and high-sensitivity C-reactive protein with metabolic syndrome in Korean adults: A cross-sectional study

By Ruan L, Ou S

Metabolic syndrome (MetS), an important metabolic risk phenotype within the broader cardiovascular-kidney-metabolic (CKM) framework, is characterized by insulin resistance and chronic low-grade inflammation; however, evidence regarding the joint relationship of these 2 biological dimensions with MetS remains limited. We analyzed cross-sectional data from 20,781 Korean adults aged ≥ 19 years who were enrolled in the Korea National Health and Nutrition Examination Survey (KNHANES) 2015–2018. MetS was classified using the National Cholesterol Education Program Adult Treatment Panel III framework with waist circumference thresholds adapted for the Korean/Asian populations. Weighted logistic regression was performed to examine the relationships between estimated glucose disposal rate (eGDR) and high-sensitivity C-reactive protein (hs-CRP) and MetS. Potential dose–response patterns were further explored using restricted cubic splines. Joint analyses, interaction analysis, and prespecified subgroup analyses were also performed. MetS was present in 29.4% of participants after weighting. In the fully adjusted model, higher eGDR was associated with lower odds of MetS per unit (OR 0.48, 95% CI: 0.47–0.49), whereas log-transformed hs-CRP showed a positive association with MetS, with higher levels corresponding to greater odds (OR 1.71, 95% CI: 1.64–1.79; both P < .001). Dose–response analyses revealed a decreasing pattern for eGDR and an increasing pattern for hs-CRP in relation to MetS. In joint analyses, progressively higher odds of MetS were observed across exposure categories, with the low-eGDR/high-hs-CRP profile corresponding to the greatest odds of MetS. No significant multiplicative interaction was detected ( P for interaction = .064). The association of the joint high-risk profile with MetS was generally consistent across subgroups and appeared stronger among younger participants and those without diabetes. Lower eGDR and higher hs-CRP levels were independently associated with MetS in Korean adults, and the low-eGDR/high-hs-CRP profile was associated with the highest odds of MetS. Their joint assessment may provide complementary information for characterizing adverse metabolic profiles within the broader CKM framework, although prospective studies are needed to determine its predictive value.

doi.org/10.1097/md.0000000000051429 Open access PubMed 42994858 Biomarkers