Xi Wenfeng, Liao Wanying, Li Jianing, Yang Yingyun, Guo Tao, Jiang Qingwei, Yang Aiming
Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, China.
Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, China.
Nutr Metab Cardiovasc Dis. 2025 May;35(5):103780. doi: 10.1016/j.numecd.2024.10.018. Epub 2024 Oct 28.
The stress hyperglycemia ratio (SHR) offers a more nuanced understanding of glucose metabolism by factoring in the background glycemia through the component of Hemoglobin A1c. The association of SHR with cardiovascular and cerebrovascular diseases has been established, but the relationship between SHR and the risk of nonalcoholic fatty liver disease (NAFLD) remains unexplored. This study aimed to elucidate the relationship between the two among U.S. adults with diabetes or prediabetes.
A total of 1409 participants diagnosed with diabetes or prediabetes from the National Health and Nutrition Examination Survey (NHANES) 2017-2020 were included in this study. Multiple logistic regression models (ranging from unadjusted to fully adjusted), restricted cubic splines, and subgroup analyses were employed to determine the relationship between SHR and NAFLD risk and to assess the stability of this relationship across different populations. The average age of all participants was 54.65 years, with males accounting for 47.91 %, and the prevalence of NAFLD being 68.77 %. A fully adjusted logistic regression model indicated a positive association between SHR levels and the risk of NAFLD. Specifically, for each one standard deviation increase in SHR, the risk of NAFLD increased by 20 % (OR, 1.2; 95 % CI, 1.0-1.4). Both the trend test and the restricted cubic splines suggested a linear relationship between the two variables (p for trend <0.05, p for nonlinear = 0.390). Subgroup analysis demonstrated that this positive association remained consistent across most subgroups.
SHR was identified as a valuable index for predicting the risk of NAFLD among U.S. adults with diabetes or prediabetes.
应激性高血糖比率（SHR）通过糖化血红蛋白成分考虑基础血糖水平，从而对葡萄糖代谢有更细致的理解。SHR与心血管疾病和脑血管疾病的关联已被确立，但SHR与非酒精性脂肪性肝病（NAFLD）风险之间的关系仍未得到探索。本研究旨在阐明美国患有糖尿病或糖尿病前期的成年人中两者之间的关系。
本研究纳入了2017 - 2020年国家健康与营养检查调查（NHANES）中1409名被诊断患有糖尿病或糖尿病前期的参与者。采用多个逻辑回归模型（从不调整到完全调整）、限制立方样条和亚组分析来确定SHR与NAFLD风险之间的关系，并评估这种关系在不同人群中的稳定性。所有参与者的平均年龄为54.65岁，男性占47.91%，NAFLD患病率为68.77%。一个完全调整的逻辑回归模型表明SHR水平与NAFLD风险之间存在正相关。具体而言，SHR每增加一个标准差，NAFLD风险增加20%（比值比，1.2；95%置信区间，1.0 - 1.4）。趋势检验和限制立方样条均表明这两个变量之间存在线性关系（趋势p < 0.05，非线性p = 0.390）。亚组分析表明，这种正相关在大多数亚组中保持一致。
SHR被确定为预测美国患有糖尿病或糖尿病前期的成年人患NAFLD风险的一个有价值的指标。
