{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:56:18Z","timestamp":1790571378338,"version":"4.1.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017594","name":"Medical Science and Technology Project of Zhejiang Province","doi-asserted-by":"publisher","award":["2025KY1674"],"award-info":[{"award-number":["2025KY1674"]}],"id":[{"id":"10.13039\/501100017594","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neovascular glaucoma (NVG) is a sight-threatening complication of proliferative diabetic retinopathy (PDR). The stress hyperglycemia ratio (SHR), which quantifies the discrepancy between acute admission glucose and chronic glycemic background, has been associated with adverse outcomes in diabetic populations, but its relationship with NVG remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the association between the SHR and prevalent NVG among patients with PDR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective cross-sectional study, patients with PDR presenting to Shaoxing People\u2019s Hospital between 2023 and 2025 were categorized according to NVG status (49 with NVG; 215 without). The SHR was calculated as admission blood glucose (mmol\/L) \u00f7 (1.59 \u00d7 HbA1c \u2212 2.59). Multivariable logistic regression estimated adjusted odds ratios (aORs), with the per-0.1-unit SHR increment as the primary effect measure; Firth penalized regression and a model excluding HbA1c were fitted as sensitivity analyses. Non-normally distributed variables were compared using the Mann\u2013Whitney U test, with a Bonferroni-adjusted threshold of 0.0063 for the eight baseline comparisons. Discrimination was internally validated by bootstrap resampling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients with NVG were younger (median 57.0 vs. 62.0 years; p &amp;lt; 0.001) and had higher SHR values (median 0.96 vs. 0.82; p &amp;lt; 0.001). The SHR was independently associated with prevalent NVG (aOR per 0.1-unit increment 1.31, 95% CI 1.12\u20131.53; p &amp;lt; 0.001); the Firth-penalized estimate was nearly identical (aOR 1.29, 95% CI 1.11\u20131.50). The events-per-variable ratio was 6.1; subgroup estimates were statistically unstable and are reported as exploratory only. The optimism-corrected C-statistic was 0.724.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this cross-sectional analysis, an elevated SHR was associated with a higher prevalence of NVG among patients with PDR. Because established NVG may itself increase admission glucose through acute stress, reverse causation cannot be excluded. These hypothesis-generating findings require confirmation in prospective, externally validated cohorts before any clinical application can be considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1945179","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:29:15Z","timestamp":1790569755000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between the stress hyperglycemia ratio and neovascular glaucoma in patients with proliferative diabetic retinopathy"],"prefix":"10.3389","volume":"17","author":[{"given":"Chenwei","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Shaoxing People\u2019s Hospital","place":["Shaoxing, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahao","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Shaoxing People\u2019s Hospital","place":["Shaoxing, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongmei","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Shaoxing People\u2019s Hospital","place":["Shaoxing, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Man","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Shaoxing People\u2019s Hospital","place":["Shaoxing, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"100109","DOI":"10.1016\/j.apjo.2024.100109","article-title":"Current research and future strategies for the management of vision-threatening diabetic retinopathy","volume":"13","author":"Li","year":"2024","journal-title":"Asia Pac J Ophthalmol (Phila)"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-019-04574-x","article-title":"Increased expression of periostin and tenascin-C in eyes with neovascular glaucoma secondary to PDR","volume":"258","author":"Ishikawa","year":"2020","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3390\/medicina58121783","article-title":"Review of neovascular glaucoma: etiology, pathogenesis, diagnosis, and treatment","volume":"58","author":"Urbonavi\u010di\u016bt\u0117","year":"2022","journal-title":"Med (Kaunas)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1186\/s12933-024-02172-8","article-title":"The prognostic value of the stress hyperglycemia ratio for all-cause and cardiovascular mortality in patients with diabetes or prediabetes: insights from NHANES 2005\u20132018","volume":"23","author":"Ding","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-2660","article-title":"Relative hyperglycemia, a marker of critical illness: introducing the stress hyperglycemia ratio","volume":"100","author":"Roberts","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"key":"B6","doi-asserted-by":"publisher","first-page":"29110","DOI":"10.1038\/s41598-024-80763-x","article-title":"Stress hyperglycemia ratio association with all-cause mortality in critically ill patients with coronary heart disease: an analysis of the MIMIC-IV database","volume":"14","author":"Chen","year":"2024","journal-title":"Sci Rep"},{"key":"B7","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1186\/s13098-024-01562-y","article-title":"The prognostic impact of stress hyperglycemia ratio on mortality in cardiogenic shock: a MIMIC-IV database analysis","volume":"16","author":"Xie","year":"2024","journal-title":"Diabetol Metab Syndr"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.4103\/ijo.ijo_1591_20","article-title":"Neovascular glaucoma: a review","volume":"69","author":"Senthil","year":"2021","journal-title":"Indian J Ophthalmol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1159\/000535059","article-title":"Diabetic retinopathy and chronic kidney disease: associations and comorbidities in a large diabetic population - 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