Stress hyperglycemia ratio and the risk of new-onset chronic diseases: results of a national prospective longitudinal study
Authors' conclusion
SHR demonstrates disease-specific associations with chronic disease development, indicating its potential value as a predictive marker for clinical risk assessment.
Study context
- Population
- Adults aged ≥45 years in the China Health and Retirement Longitudinal Study (CHARLS)
- Participants
- 8,942 adults
- Exposure
- Per SD increase in stress hyperglycemia ratio (SHR)
- Outcome
- New-onset chronic conditions (14 disease-specific cohorts)
Methodological detailsnationwide, multivariable-adjusted Cox proportional hazards models, restricted cubic splines, 14 disease-specific cohorts
- Nationwide
- Multivariable-adjusted Cox proportional hazards models
- Restricted cubic splines
- 14 disease-specific cohorts
Main finding
As reported in the abstract
Incident chronic diseases per SD increase in SHR
- Hypertension: HR 1.30, 95% CI 1.06-1.60; P < 0.001
- Dyslipidemia: HR 1.43, 95% CI 1.17-1.74; P < 0.001
- Diabetes: HR 2.30, 95% CI 1.82-2.91; P < 0.001
- Liver disease: HR 1.65, 95% CI 1.21-2.26; P = 0.002
- Lung disease (lower risk): HR 0.67, 95% CI 0.50-0.89; P = 0.006
- Hazard ratios (HRs) per SD increase in SHR
Observational data: associations, not effects.
Further findings
Dose-response (restricted cubic splines)
- Nonlinear relationship between SHR and diabetes risk (P-nonlinear = 0.02); linear for other outcomes
Subgroup analyses
- Consistent across demographic strata (P-interaction > 0.05)
Original publication
Stress hyperglycemia ratio and the risk of new-onset chronic diseases: results of a national prospective longitudinal study. Cardiovasc Diabetol. Published 14 June 2025. doi:10.
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