Evidence map›Paper›PMID 42092957›Full record

ArticleLipids in health and disease2026

Cumulative stress hyperglycemia ratio exposure and dynamic trajectories reveal prognostic determinants of acute hyperlipidemic pancreatitis: an 5-year cohort study.

Yiji Chen, Jianhua Wan, Wenqing Shu, Xiaoyu Yang, Huajing Ke, Wenhua He, Yin Zhu, Nonghua Lu, Liang Xia

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Article in Lipids in health and disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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5 · Who and what money

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9 authors.

Yiji Chen *Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Nanchang, Jiangxi, 330006, China.
Jianhua Wan *Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Nanchang, Jiangxi, 330006, China.
Wenqing ShuDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Nanchang, Jiangxi, 330006, China.
Xiaoyu YangDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Nanchang, Jiangxi, 330006, China.
Huajing KeDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Nanchang, Jiangxi, 330006, China.
Wenhua HeDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Nanchang, Jiangxi, 330006, China.
Yin ZhuDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Nanchang, Jiangxi, 330006, China.
Nonghua LuDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Nanchang, Jiangxi, 330006, China.
Liang XiaDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Nanchang, Jiangxi, 330006, China. ndyfy02137@ncu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe stress hyperglycemia ratio (SHR) and glycemic variability (GV) both reflect acute glycemic fluctuations, with established roles in cardiovascular and stroke diseases. However, their prognostic value in acute hyperlipidemic pancreatitis (HTG-AP) remains underexplored. Traditional assessments based on single measurements fail to capture the dynamic evolution. Therefore, this study aims to evaluate the early predictive value of Cumulative stress hyperglycemia ratio (CumSHR) and trajectory combined with GV in patients with hyperlipidemic pancreatitis.

methodsThis study collected data from 959 patients with HTG-AP. SHR and GV were calculated using standardized formulas; CumSHR was derived from the area under the curve (AUC) based on SHR data from the 7 days prior to admission. Multivariable analyses and RCS analysis assessed whether CumSHR predicted severe hyperlipidemic acute pancreatitis (HTG-SAP). Subgroup stratification was performed based on clinically distinct glucose metabolic states, while Latent class growth mixture model (LCGMM) identified dynamic SHR trajectory sub-phenotypes. Kaplan-Meier (K-M) curves compared survival rates across different risk trajectory groups. Finally, machine learning models predicted HTG-SAP risk, and SHapley Additive exPlanations (SHAP) identified key predictors.

resultsIn the Jiangxi cohort, 162 cases (16.9%) of HTG-AP developed HTG-SAP. RCS analysis demonstrated a U-shaped association between CumSHR and HTG-SAP and persistent organ failure (POF) (P < 0.001). The LCGMM identified three dynamic trajectories: the sustained high-value group (SHG-T3) exhibited the highest risk of HTG-SAP (55.6%, compared with 10.6% in the low-value gradually decreasing group [LDG-T1]). Subsequently, stratified into normal glucose regulation (NGR), pre-diabetes Mellitus (Pre-DM), and diabetes mellitus (DM), high CumSHR + high GV showed increased risk compared to low CumSHR + low LGV (P < 0.05). Among machine learning models predicting HTG-SAP risk, the Naive-Bayes model demonstrated the highest predictive accuracy. SHAP analysis identified CumSHR as one of the most important predictors.

conclusionsThis study demonstrates that CumSHR exhibits significant association with early assessment of severe conditions in patients with HTG-AP, with its trajectory effectively capturing dynamic changes to compensate for the limitations of static prediction.

Indexed as

HyperglycemiaHyperlipidemiasPancreatitisAcute DiseaseAdultAgedBlood GlucoseCohort StudiesFemaleHumansKaplan-Meier EstimateMachine LearningMaleMiddle AgedPrognosisRisk FactorsBlood GlucoseAcute hyperlipidemic pancreatitisAcute necrotic collectionCumSHRGVHTG-APPersistent organ failureSHR trajectory

Identifiers

PMID42092957
PMCPMC13312519

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.