ArticleCardiovascular diabetology2024
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.
Article in Cardiovascular diabetology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 100 papers, 1 of them a synthesis that pooled it.
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Who cites it
100 citing papers in PubMed, 1 synthesis or guideline pooled it, 99 citations in OpenAlex.
- Relationship between stress hyperglycaemic ratio (SHR) and critical illness: a systematic review.Cardiovascular diabetology · 2025Pooled it
- Evaluative performance of triglyceride-glucose-frailty index versus surrogate insulin resistance indices for advanced cardiovascular-kidney-metabolic syndrome, cardiometabolic multimorbidity, and mortality: the role of estimated glomerular filtration rate.Cardiovascular diabetology · 2026Article
- Mid-upper arm circumference and diabetes/prediabetes in children and adolescents: A cross-sectional study using NHANES data.Medicine · 2026Article
- Integrated Assessment of Stress Hyperglycemia and Glycemic Variability for Mortality Prediction in Non-St-Segment Elevation Myocardial Infarction and St-Segment Elevation Myocardial Infarction: A Glycometabolic Phenotype-Stratified Analysis.Reviews in cardiovascular medicine · 2026Article
- Advanced prediction of cardiovascular-kidney-metabolic syndrome using eight machine learning models and 24 composite indices.BMC cardiovascular disorders · 2026Article
- Combined assessment of triglyceride-glucose index and stress hyperglycemia ratio to predict all-cause mortality in critically ill patients with intracerebral hemorrhage.BMC neurology · 2026Article
- Article
- Stress Hyperglycemia Ratio Predicts 28-Day Mortality in Patients with AMI Cardiogenic Shock: Insights from a Large-Scale Cohort.Journal of clinical medicine · 2026Article
- Association between stress hyperglycemia ratio and cognitive function in older patients with diabetes or prediabetes: a cross-sectional study from the NHANES.Endocrine journal · 2026Article
- The Association Between Stress-Induced Hyperglycemia Ratio and Increased Urinary Albumin Excretion in Patients With Hypertension: A Population-Based Study.The Kaohsiung journal of medical sciences · 2026Article
- U-shaped association between estimated glomerular filtration rate and mortality in HSV-positive adults: A retrospective cohort study.Medicine · 2026Article
- Diabetes Mellitus Facilitates Gallstone Formation Through CXCR2-NETs-Mediated Liver-Bile Barrier Damage.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Risk Factors for Mortality in Critically Ill Patients with Diabetes Admitted to the ICU: A Single-Center Retrospective Observational Study.Journal of clinical medicine · 2026Article
- Prognostic stratification of cardiovascular risk and cardiac remodeling in prediabetes: a multimodal analysis comparing ADA and WHO/IEC diagnostic criteria.Cardiovascular diabetology · 2026Observational
- Association of the Stress Hyperglycemia Ratio with Advanced Liver Fibrosis and Mortality in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease: An Analysis of NHANES.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2026Article
- An LLM-assisted framework for accelerated and verifiable clinical hypothesis testing from electronic health records.medRxiv : the preprint server for health sciences · 2026Article
- Acute-to-chronic glycemic ratio: a promising biomarker for prognosis of diabetic foot ulcers in a multi-center cohort study.Diabetology & metabolic syndrome · 2026Article
- Stress hyperglycemia ratio is associated with microcirculatory resistance in patients with ST-segment elevation myocardial infarction.BMC cardiovascular disorders · 2026Observational
- Relation of the stress hyperglycaemia ratio to residual risk in anticoagulated patients with atrial fibrillation: A report from the prospective Murcia AF Project III cohort.Diabetes, obesity & metabolism · 2026Article
- Stress hyperglycemia ratio and mortality risk in cardiometabolic multimorbidity: a multicenter retrospective study.BMC cardiovascular disorders · 2026Article
40 more citing papers are in PubMed but not listed here.
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe 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.
methodsThis 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.
resultsDuring 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 < 0.001). Multivariate Cox regression analyses indicated that, compared to the 1st quartile, the 4th quartile was associated with higher all-cause mortality (model 1: HR = 0.89, 95% CI 0.74-10.7, P = 0.226; model 2: HR = 1.24, 95% CI 1.03-1.49, P = 0.026; model 3: HR = 1.30, 95% CI 1.08-1.57, P = 0.006). The 3rd quartile was associated with lower cardiovascular mortality than quartile 1 (model 1: HR = 0.47, 95% CI 0.32-0.69, P < 0.001; model 2: HR = 0.66, 95% CI 0.45-0.96, P = 0.032; model 3: HR = 0.68, 95% CI 0.46-0.99, P = 0.049). There was a U-shaped association between SHR and all-cause mortality and an L-shaped association between SHR and cardiovascular mortality, with inflection points of SHR for poor prognosis of 0.87 and 0.93, respectively.
conclusionSHR is related to all-cause and cardiovascular mortality in patients with diabetes or prediabetes. SHR may have predictive value in those patients.
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