A recent study has identified a significant association between the stress hyperglycemia ratio (SHR) and all-cause mortality risk in patients with psoriasis. The findings, published in Scientific Reports, suggest that higher SHR values are linked to an increased risk of death in these patients, shedding new light on the long-term health implications of psoriasis beyond its physical symptoms.
Psoriasis, a chronic skin condition, has often been viewed primarily through the lens of dermatological concerns. However, this study highlights the broader health risks associated with the condition, particularly the role of SHR as a predictor of mortality. Researchers emphasized that these findings could lead to quicker identification of high-risk individuals and more targeted medical interventions.
Stress hyperglycemia, a condition commonly seen in critically ill patients, is thought to reflect the severity of underlying health issues. While some researchers have proposed that this hyperglycemia is adaptive and may support survival during acute illness, evidence has been mixed regarding its impact on overall health outcomes. Despite attempts to control hyperglycemia in hospital settings, studies have shown that such efforts often do not improve patient outcomes in intensive care units.
The study, led by researchers using data from the National Health and Nutrition Examination Survey (NHANES), assessed a cohort of 288 psoriasis patients from a larger sample of 50,939 individuals surveyed between 2003 and 2014. The analysis focused on the relationship between SHR and long-term mortality risk, using mortality data categorized by the International Classification of Diseases, Tenth Revision (ICD-10).
Patients in the study had a mean age of 49.41 years, and the group was nearly evenly split between genders. The data revealed that higher SHR levels were associated with increased body mass index (BMI), waist circumference, and prevalence of diabetes, as well as higher levels of fasting plasma glucose and hemoglobin A1C. Notably, SHR was found to be a strong predictor of mortality risk. Patients with the highest SHR values had a nearly 11-fold increased risk of dying compared to those in the lowest tertile, even after accounting for confounding factors such as age and underlying health conditions.
During an average follow-up period of just over 9 years, 38 patients died. While these findings are compelling, the researchers noted several limitations, including the relatively small sample size, which may limit the generalizability of the results. Additionally, the study’s focus on a US-based cohort means the results may not apply equally to other populations with different genetic and environmental factors. Excluding individuals with incomplete data may also have introduced selection bias.
Despite these limitations, the researchers argue that this is the first study to clearly establish a link between SHR and all-cause mortality in psoriasis patients. The study also identified a specific SHR cut-off value that could help healthcare providers identify those at greatest risk for poor clinical outcomes.
“Our findings contribute to a more reliable and cost-effective way of identifying high-risk patients with psoriasis,” the researchers concluded, calling for further studies to validate these results in broader, more diverse populations.
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