Higher eGDR linked to lower gastrointestinal cancer mortality in UK cohort

In a prospective cohort study of 369,447 UK Biobank participants initially free of cancer, higher estimated glucose disposal rate (eGDR) was associated with lower subsequent gastrointestinal cancer mortality. During a mean follow-up of 13.5 years, 4,305 gastrointestinal cancer-related deaths were recorded. Associations with eGDR remained significant for mortality from several individual cancer sites after correction for false discovery rate.

Researchers assessed eGDR, used as a surrogate of insulin sensitivity, together with two other insulin-resistance indices: the triglyceride-to-high-density-lipoprotein-cholesterol ratio, TG/HDL-C, and the triglyceride-glucose index, TyG. Fine-Gray models were used to evaluate associations between these measures and gastrointestinal cancer mortality among UK Biobank participants who had no cancer at baseline.

For the pooled gastrointestinal cancer outcome, the reported subdistribution hazard ratio for higher eGDR was 0.67, with a 95% confidence interval of 0.61–0.74 and a P value below 0.001. The association also remained significant after false discovery rate correction for EC, ESCC, CRC, LC and PC mortality, according to the study abstract. These results concern the measured associations between baseline metabolic markers and later cancer-related mortality.

TyG was associated with the pooled gastrointestinal cancer outcome, whereas TG/HDL-C was not. Both TG/HDL-C and TyG remained associated with LC mortality, indicating that the findings for the two indices were limited and differed between the combined gastrointestinal endpoint and the site-specific outcome. The authors characterized the associations involving TG/HDL-C and TyG as modest and site-specific.

Subgroup analyses were exploratory. As an observational study, the research did not establish that raising eGDR or changing either insulin-resistance index would reduce gastrointestinal cancer mortality, and the authors said the findings do not establish clinical utility. The results therefore identify an association in the studied UK Biobank population rather than a causal effect or a basis for clinical use.

Subject of Research: Associations of eGDR and insulin-resistance indices with gastrointestinal cancer mortality in the UK Biobank

Article Title: eGDR and gastrointestinal cancer mortality in the UK Biobank: a prospective cohort study

Article References: Yang, C., Plum, P. S., Ebert, T., Köppe, J., Gockel, I., & Thieme, R. (2026). eGDR and gastrointestinal cancer mortality in the UK Biobank: a prospective cohort study. BMC Cancer, 26(1), Article 1060. https://doi.org/10.1186/s12885-026-16931-1

Image Credits: AI Generated

DOI: 10.1186/s12885-026-16931-1

Keywords: eGDR, insulin sensitivity, gastrointestinal cancer, cancer mortality, UK Biobank, prospective cohort, insulin resistance, TyG, TG/HDL-C, survival analysis, gastrointestinal, cancer