The prognostic value of the stress hyperglycemia ratio for all-cause and cardiovascular mortality in patients with diabetes or prediabetes: insights from NHANES 2005-2018

• Published in: Cardiovascular diabetology 2024-02, Vol.23 (1), p.84-84, Article 84
• Main Authors: Ding, Lei, Zhang, Hongda, Dai, Cong, Zhang, Aikai, Yu, Fengyuan, Mi, Lijie, Qi, Yingjie, Tang, Min
• Format: Article
• Language: English
• Subjects: Alcohol use; All-cause mortality; Anemia; Angina pectoris; Blood pressure; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cardiovascular mortality; Cerebrovascular disease; Cholesterol; Confounding (Statistics); Diabetes; Diabetes mellitus; Diabetes Mellitus - epidemiology; Females; Glucose; Heart attacks; Hemoglobin; High density lipoprotein; Hispanic Americans; Humans; Hyperglycemia; Hyperglycemia - complications; Hyperglycemia - diagnosis; Hypertension; Medical laboratories; Medical prognosis; Mortality; Nutrition Surveys; Overweight; Prediabetes; Prediabetic State - epidemiology; Prognosis; Questionnaires; Stress hyperglycemia ratio (SHR)
• ISSN: 1475-2840; 1475-2840
• DOI: 10.1186/s12933-024-02172-8

The Stress hyperglycemia ratio (SHR) is a novel marker reflecting the true acute hyperglycemia status and is associated with clinical adverse events. The relationship between SHR and mortality in patients with diabetes or prediabetes is still unclear. This study aimed to investigate the predictive value of the SHR for all-cause and cardiovascular mortality in patients with diabetes or prediabetes. This study included 11,160 patients diagnosed with diabetes or prediabetes from the National Health and Nutrition Examination Survey (2005-2018). The study endpoints were all-cause and cardiovascular mortality, and morality data were extracted from the National Death Index (NDI) up to December 31, 2019. Patients were divided into SHR quartiles. Cox proportion hazards regression was applied to determine the prognostic value of SHR. Model 1 was not adjusted for any covariates. Model 2 was adjusted for age, sex, and race. Model 3 was adjusted for age, sex, race, BMI, smoking status, alcohol use, hypertension, CHD, CKD, anemia, and TG. During a mean follow-up of 84.9 months, a total of 1538 all-cause deaths and 410 cardiovascular deaths were recorded. Kaplan-Meier survival analysis showed the lowest all-cause mortality incidence was in quartile 3 (P