Stress-induced hyperglycemia ratio and gestational diabetes mellitus: a cross-sectional study based on NHANES database.

Background: Stress-induced hyperglycemia ratio (SHR) has shown strong correlations with diabetes risk. However, its relationship with gestational diabetes mellitus (GDM) remains an area of limited research. Objective: Based on the National Health and Nutrition Examination Survey (NHANES) database, this cross-sectional study aims to explore the association between SHR and GDM. Methods: The study included 461 pregnant women from NHANES between 1999 and 2016. Logistic regression analysis was performed to investigate the relation between SHR and GDM, as well as the weighted tertiles of SHR. Stratified and subgroup analyses assessed the association between SHR and GDM. Restricted cubic splines (RCS) delineated the nonlinear relationship between SHR and GDM. Moreover, a two-segment linear regression model was employed to test the threshold effect of SHR on GDM. Stratified analysis was conducted by stratifying by months of pregnancy. Results: Among the 461 eligible women included in the study, SHR was a critical risk factor for GDM. Higher SHR values were associated with an elevated likelihood of developing GDM after accounting for other variables (OR: 1.77, 95% CI: 1.37-2.28, Conclusion: SHR is significantly positively correlated with an increased risk of GDM in early pregnancy. These results highlight the potential utility of SHR as a clinical marker for early identification and intervention in GDM risk cases.