ArticleCardiovascular diabetology2025
The additive effect of the stress hyperglycemia ratio on type 2 diabetes: a population-based cohort study.
Article in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association between stress hyperglycemia ratio and prognosis of patients hospitalized with COVID-19: A meta-analysis.Journal of diabetes investigation · 2026Pooled it
- Association Between Stress Hyperglycemia Ratio and Cardiovascular Outcomes in Patients Who Underwent Complex Percutaneous Coronary Intervention According to Different Glycemic Status.Journal of the American Heart Association · 2026Article
- Estimated glucose disposal rate outperforms inflammation surrogate markers in predicting cardiometabolic multimorbidity among middle-aged and older adults.Cardiovascular diabetology · 2026Article
- Sleep variability and risk of type 2 diabetes mellitus: Mediating role of social participation in a national longitudinal cohort study.Medicine · 2026Article
- Association between estimated glucose disposal rate and heart disease events in adults with overweight or obesity: a prospective cohort study.Journal of translational medicine · 2026Article
- Stress-induced hyperglycemia ratio and gestational diabetes mellitus: a cross-sectional study based on NHANES database.Therapeutic advances in endocrinology and metabolism · 2026Article
- Simultaneous assessment of stress hyperglycemia ratio and glucose variability to predict all-cause mortality in sepsis patients across different glucose metabolic states: an observational cohort study with interpretable machine learning approach.International journal of surgery (London, England) · 2026Observational
- Stress hyperglycemia ratio and the risk of new-onset chronic diseases: results of a national prospective longitudinal study.Cardiovascular diabetology · 2025Article
- Stress hyperglycemia ratio: a novel prognostic marker in chronic kidney disease.Diabetology & metabolic syndrome · 2025Article
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Authors and funding
10 authors.
Funding
Abstract
backgroundThe stress hyperglycemia ratio (SHR) has recently gained attention as a marker for acute hyperglycemia, which has been linked to adverse clinical outcomes. However, its independent role in the development of type 2 diabetes (T2D) remains understudied. This cohort study aimed to assess the association between SHR and the incidence of T2D.
methodsThe study included 8978 participants aged 45 or older, free of diabetes at baseline, from the China Health and Retirement Longitudinal Study (CHARLS). Incident T2D up to December 31, 2020, was the primary outcome. Participants were divided into SHR quartiles, and Cox proportional hazards regression and fine-gray competing risk models were used to assess SHR's association with T2D onset, adjusting for fasting glucose and HbA1c.
resultsThe mean age of participants was 59.0 ± 9.5 years, and 51.5% were women. Over a mean follow-up of 7.8 years, 1084 participants developed T2D. Cox regression analysis revealed that individuals in the highest SHR quartile had a significantly higher risk of T2D onset compared to those in the lowest quartile (HR 1.48, 95% CI 1.26-1.75, P for trend < 0.001). Stratified analyses by sex, obesity, and smoking showed consistent results. Adding SHR to fasting glucose and HbA1c models improved the AUC for T2D prediction (DeLong Test, P = 0.013).
conclusionSHR is independently associated with incident T2D, suggesting its potential use in the risk stratification and prediction for T2D, beyond glucose and HbA1c.
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