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Background <p>The stress hyperglycemia ratio (SHR) has been reported to be closely associated with various diseases and prognoses. However, the relationship between SHR and elevated blood pressure (EBP) in adolescents aged 12–17 remains unclear.</p> Methods <p>This cross-sectional study included U.S. adolescents from the 1999–2016 National Health and Nutrition Examination Survey (NHANES). The primary outcome was EBP. SHR was calculated by the formula [FPG (mmol/L)] / [1.59 × HbA1c (%) − 2.59]. Patients were divided into SHR quartiles. Weighted multivariable logistic regression models, subgroup analysis, restricted cubic spline (RCS) and receiver operating characteristic (ROC) curves, sensitivity analyses were used to evaluate the associations.</p> Results <p>A total of 3676 participants were included. Among them, 543 participants had EBP. In the fully adjusted model (Model 3), per SD increase in SHR was associated with a 17% higher odds of EBP (aOR 1.17, 95%CI 1.04–1.32, <i>p</i> = 0.009). Compared with the lowest quartile, participants in the highest quartile had a 95% higher odds of EBP (aOR 1.90, 95%CI 1.29–2.79, <i>p</i> for trend &lt; 0.001). RCS analysis revealed a significant linear association between SHR and EBP (<i>p</i> for non-linearity &gt; 0.05). ROC curves indicated that SHR had modest predictive performance for EBP in adolescents (AUC 0.723, 95%CI 0.699–0.747).</p> Conclusions <p>This study suggests that higher SHR levels are positively associated with the prevalence of EBP among U.S. adolescents aged 12–17.</p>

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Association between the stress hyperglycemia ratio and elevated blood pressure among U.S. adolescents aged 12–17

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  • 发表日期：

    2025年10月28日

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  • Liujie Zheng,
  • Guoqiang Li,
  • Yan Liu,
  • Zhiyong Hou

摘要

Background

The stress hyperglycemia ratio (SHR) has been reported to be closely associated with various diseases and prognoses. However, the relationship between SHR and elevated blood pressure (EBP) in adolescents aged 12–17 remains unclear.

Methods

This cross-sectional study included U.S. adolescents from the 1999–2016 National Health and Nutrition Examination Survey (NHANES). The primary outcome was EBP. SHR was calculated by the formula [FPG (mmol/L)] / [1.59 × HbA1c (%) − 2.59]. Patients were divided into SHR quartiles. Weighted multivariable logistic regression models, subgroup analysis, restricted cubic spline (RCS) and receiver operating characteristic (ROC) curves, sensitivity analyses were used to evaluate the associations.

Results

A total of 3676 participants were included. Among them, 543 participants had EBP. In the fully adjusted model (Model 3), per SD increase in SHR was associated with a 17% higher odds of EBP (aOR 1.17, 95%CI 1.04–1.32, p = 0.009). Compared with the lowest quartile, participants in the highest quartile had a 95% higher odds of EBP (aOR 1.90, 95%CI 1.29–2.79, p for trend < 0.001). RCS analysis revealed a significant linear association between SHR and EBP (p for non-linearity > 0.05). ROC curves indicated that SHR had modest predictive performance for EBP in adolescents (AUC 0.723, 95%CI 0.699–0.747).

Conclusions

This study suggests that higher SHR levels are positively associated with the prevalence of EBP among U.S. adolescents aged 12–17.