The prognostic significance of stress hyperglycemia ratio in evaluating all-cause and cardiovascular mortality risk among individuals across stages 0–3 of cardiovascular–kidney–metabolic syndrome: evidence from two cohort studies

作者：Mo‐Yao Tan, Yujun Zhang, Si-Xuan Zhu, Shan Wu, Ping Zhang, Ming Gao · 发表于：Cardiovascular Diabetology · 年份：2025 · DOI：10.1186/s12933-025-02689-6 · 被引用次数：62 · 研究领域：Hyperglycemia and glycemic control in critically ill and hospitalized patients、Chronic Kidney Disease and Diabetes、Cardiovascular Function and Risk Factors

BACKGROUND: The American Heart Association (AHA) proposed the concept of cardiovascular-kidney-metabolic (CKM) syndrome, underscoring the interconnectedness of cardiovascular, renal, and metabolic diseases. The stress hyperglycemia ratio (SHR) represents an innovative indicator that quantifies blood glucose fluctuations in patients experiencing acute or subacute stress, correlating with detrimental clinical effects. Nevertheless, the prognostic significance of SHR within individuals diagnosed with CKM syndrome in stages 0 to 3, particularly with respect to all-cause or cardiovascular disease (CVD) mortality risks, has not been fully understood yet. METHODS: The current study analyzed data from 9647 participants with CKM syndrome, covering stages 0 to 3, based on the NHANES (National Health and Nutrition Examination Survey) collected from 2007 to 2018. In this study, the primary exposure variable was the SHR, computed as fasting plasma glucose divided by (1.59 * HbA1c - 2.59). The main endpoints of study were all-cause mortality as well as CVD mortality, with death registration data sourced through December 31, 2019. The CHARLS database (China Health and Retirement Longitudinal Study) was utilized as validation to enhance the reliability of the findings. RESULTS: This study included 9647 NHANES participants, who were followed for a median duration of 6.80 years. During this period, 630 all-cause mortality cases and 135 CVD-related deaths in total were recorded. After full adju...