Department of Dermatology and Venereology, People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Clinical Research Center for Dermatologic Diseases, Xinjiang Key Laboratory of Dermatology Research, Urumqi, 830001, China.
Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Sci Rep. 2024 Oct 30;14(1):26113. doi: 10.1038/s41598-024-77019-z.
Aims The stress hyperglycemia ratio (SHR) is a valuable biomarker of acute hyperglycemia, significantly correlated with unfavorable prognosis in various conditions. However, its impact on Psoriasis has not been studied. We explored the association between SHR and long-term mortality in psoriasis patients. Methods We conducted a prospective cohort study with 288 psoriasis patients from the 2003-2006 and 2009-2014 NHANES. Participants were divided into three groups based on SHR tertiles: T1 (SHR ≤ 0.870), T2 (SHR 0.870-0.958), and T3 (SHR ≥ 0.958). Cox regression and Kaplan-Meier analyses assessed the correlation between SHR and mortality, while restricted cubic splines explored non-linear correlations. ROC analyses determined the optimal SHR cut-off value for predicting clinical outcomes. Results Out of 288 Psoriasis patients, 38 all-cause deaths occurred during an average follow-up of 112.13 ± 45.154 months. Kaplan-Meier analysis indicated that higher SHR values were linked to an increased risk of all-cause mortality (log-rank P = 0.049). A U-shaped relationship was observed between SHR and all-cause mortality (P for non-linear = 0.028). Spearman correlation revealed significant associations between SHR and WC, BMI, neutrophil, monocyte, lymphocyte counts, SCr, uric acid, DM and MetS (all P < 0.05). After adjusting for confounders, multivariate Cox regression showed that SHR was associated with a 10.937-fold risk of all-cause mortality. ROC curve analysis identified an optimal SHR cut-off value of 1.045 for predicting long-term all-cause mortality in psoriasis patients. Conclusions Elevated SHR value independently correlates with all-cause mortality in Psoriasis patients, displaying a U-shaped relationship with clinical endpoints. An optimal SHR cut-off value of 1.045 has been determined for predicting clinical outcomes.
目的 应激性高血糖比值（SHR）是急性高血糖的有价值的生物标志物，与各种情况下的不良预后显著相关。然而，它在银屑病中的影响尚未得到研究。我们探讨了 SHR 与银屑病患者长期死亡率之间的关系。
方法 我们进行了一项前瞻性队列研究，纳入了来自 2003-2006 年和 2009-2014 年 NHANES 的 288 名银屑病患者。根据 SHR 三分位将参与者分为三组：T1（SHR≤0.870）、T2（SHR 0.870-0.958）和 T3（SHR≥0.958）。Cox 回归和 Kaplan-Meier 分析评估了 SHR 与死亡率之间的相关性，而限制立方样条探索了非线性相关性。ROC 分析确定了预测临床结局的最佳 SHR 截断值。
结果 在 288 名银屑病患者中，平均随访 112.13±45.154 个月期间发生了 38 例全因死亡。Kaplan-Meier 分析表明，较高的 SHR 值与全因死亡风险增加相关（对数秩 P=0.049）。SHR 与全因死亡率之间呈 U 形关系（非线性 P=0.028）。Spearman 相关分析显示，SHR 与 WC、BMI、中性粒细胞、单核细胞、淋巴细胞计数、SCr、尿酸、糖尿病和代谢综合征均显著相关（均 P<0.05）。在调整混杂因素后，多变量 Cox 回归显示 SHR 与全因死亡风险增加 10.937 倍相关。ROC 曲线分析确定了 SHR 预测银屑病患者长期全因死亡率的最佳截断值为 1.045。
结论 SHR 值升高与银屑病患者的全因死亡率独立相关，与临床终点呈 U 形关系。已确定 SHR 的最佳截断值为 1.045，用于预测临床结局。
