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
Authors' conclusion
SHR is related to all-cause and cardiovascular mortality in patients with diabetes or prediabetes. SHR may have predictive value in those patients.
Study context
- Population
- Patients with diabetes or prediabetes, NHANES 2005–2018
- Participants
- 11,160 patients
- Exposure
- Stress hyperglycemia ratio (SHR) quartiles
- Outcome
- All-cause and cardiovascular mortality
- Follow-up
- Mean 84.9 months
Methodological detailsNHANES 2005–2018, mortality linked to National Death Index
- NHANES 2005–2018
- Mortality linked to National Death Index
Main finding
As reported in the abstract
All-cause mortality
Q4 vs Q1Hazard ratio (95% CI)P value
Model 1 (unadjusted)
0.89(0.74–10.7)
P = 0.226Model 2 (age, sex, race)
1.24(1.03–1.49)
P = 0.026Model 3 (fully adjusted)
1.30(1.08–1.57)
P = 0.006- All-cause deaths
- 1538
- Lowest all-cause mortality incidence in Q3 (Kaplan-Meier)
- P < 0.001
- U-shaped association of SHR with all-cause mortality; inflection point
- 0.87
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Cardiovascular mortality · mean follow-up 84.9 monthsQ3vs Q1Model 1 (unadjusted) | 0.47 (0.32–0.69) | P < 0.001 | |
| Cardiovascular mortality · mean follow-up 84.9 monthsQ3vs Q1Model 2 (age, sex, race) | 0.66 (0.45–0.96) | P = 0.032 | |
| Cardiovascular mortality · mean follow-up 84.9 monthsQ3vs Q1Model 3 (fully adjusted) | 0.68 (0.46–0.99) | P = 0.049 | |
| 0.20.5125Hazard ratio (log scale) |
- Cardiovascular mortality — Cardiovascular deaths
- 410
- Cardiovascular mortality — L-shaped association of SHR with cardiovascular mortality; inflection point
- 0.93
Original publication
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. Cardiovasc Diabetol. Published 28 February 2024. doi:10.
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