The additive effect of the stress hyperglycemia ratio on type 2 diabetes: a population-based cohort study
Main finding · T2D onsetResult — go to the resultHazard ratio 1.48 95% CI 1.26–1.75Authors' conclusion
SHR is independently associated with incident T2D, suggesting its potential use in the risk stratification and prediction for T2D, beyond glucose and HbA1c.
Study context
- Population
- Participants aged ≥45 years, free of diabetes at baseline, China Health and Retirement Longitudinal Study (CHARLS); mean age 59.0 ± 9.5 years, 51.5% women
- Participants
- 8,978 participants
- Exposure
- Highest vs lowest stress hyperglycemia ratio (SHR) quartile
- Outcome
- Incident T2D
- Follow-up
- Up to December 31, 2020
Methodological detailsCox proportional hazards regression, Fine-Gray competing risk models, adjusted for fasting glucose and HbA1c
- Cox proportional hazards regression
- Fine-Gray competing risk models
- Adjusted for fasting glucose and HbA1c
Main finding
T2D onset · mean follow-up 7.8 years
Hazard ratio
1.48
95% CI 1.26–1.75
P < 0.001 for trend
Highest SHR quartilevs Lowest SHR quartile
HR 1.48 (95% CI 1.26–1.75); P for trend < 0.001
As reported in the abstract
- Participants who developed T2D
- 1084
Observational data: associations, not effects.
Further findings
Stratified analyses by sex, obesity and smoking
- Consistent results
AUC for T2D prediction, adding SHR to fasting glucose and HbA1c models
- Improved AUC (DeLong Test)
- P = 0.013
Original publication
The additive effect of the stress hyperglycemia ratio on type 2 diabetes: a population-based cohort study. Cardiovasc Diabetol. Published 6 January 2025. doi:10.
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