Association of stress hyperglycemia ratio with presence and severity of chronic kidney disease among US adults with diabetes mellitus

医学 糖尿病 肾脏疾病 内科学 疾病 2型糖尿病 内分泌学
作者
Wenguang Lai,Yaxin Meng,Yang Zhou,Tingting Zhang,Baoyuan Zhang,Zhidong Huang,Zhiyong Gao
出处
期刊:Frontiers in Endocrinology [Frontiers Media]
卷期号:15
标识
DOI:10.3389/fendo.2024.1446390
摘要

Background Among diabetes mellitus (DM) patients, stress hyperglycemia ratio (SHR) is a strong predictor of short- and long-term prognosis, and adverse cardiovascular events. However, whether SHR is associated with increased risk of presence and severity of chronic kidney (CKD) disease remains undetermined. Methods Patients with DM from the National Health and Nutrition Examination Survey (NHANES) database (1999–2020) were included and divided into 5 groups according to their SHR level (quintile 1 to 5). Study outcomes were CKD, advanced CKD (ACKD), and CKD severity. Logistic regression and restricted cubic spline (RCS) were used to assess the association between the SHR and outcomes. Results Totally, 6,119 patients were included. After adjustment, compared to patients with SHR in quintile 3 (as reference), the risk of CKD is 1.50 (P<0.001) for quintile 1, 1.23 (P=0.140) for quintile 2, 1.95 (P<0.001) for quintile 4, and 1.79 (P<0.001) for quintile 5. For the risk of ACKD, the OR is 1.46 (P=0.410) for quintile 1, 1.07 (P=0.890) for quintile 2, 3.28 (P=0.030) for quintile 4, and 3.89 (P=0.002) for quintile 5. For the CKD severity, the OR is 1.46 (P<0.001) for quintile 1, 1.20 (P=0.163) for quintile 2, 1.84 (P<0.001) for quintile 4, and 1.83 (P<0.001) for quintile 5. RCS analysis also showed a U-shaped association between SHR and outcomes (All P for nonlinearity<0.05). Conclusion Our study demonstrated that too low or too high SHR level is significantly associated with adverse renal outcomes in patients with DM.
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