{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T04:39:26Z","timestamp":1788237566153,"version":"build-2803163510"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Diabetic retinopathy (DR) is a major microvascular complication of type 2 diabetes mellitus (T2DM), and traditional glycaemic control indicators struggle to comprehensively predict its risk. This study aims to investigate the association between the stress hyperglycaemia ratio (SHR), fasting blood glucose\/glycated hemoglobin (FBG\/HbA1c), postprandial 2-h glucose\/glycated hemoglobin (P2hBG\/HbA1c) with DR in T2DM patients, and the mediating effects of non-high-density lipoprotein cholesterol\/high-density lipoprotein cholesterol ratio (NHHR) and triglycerides\/high-density lipoprotein cholesterol ratio (TG\/HDL-C).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study is a retrospective cross-sectional study based on inpatients at a single center. A total of 1,924 T2DM patients were enrolled and grouped according to DR status and quartiles of SHR, FBG\/HbA1c, and P2hBG\/HbA1c. Multivariate logistic regression, subgroup analysis, restricted cubic spline (RCS) analysis, and mediation effect analysis were employed to validate the associations between indicators and their underlying mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The DR group exhibited a considerably higher proportion of participants in the upper quartiles for SHR, FBG\/HbA1c and P2hBG\/HbA1c. In the fully adjusted model (Model 4), the following comparisons were made between the Q1 quartile and the Q2, Q3 and Q4 quartiles: Q2 (OR = 1.65, 95% CI: 1.24\u20132.21), Q3 (OR = 1.75, 95% CI: 1.31\u20132.33) and Q4 (OR = 2.51, 95% CI: 1.88\u20133.36). For FBG\/HbA1c, the following comparisons were made between Q2 (OR = 1.42, 95% CI: 1.06\u20131.91), Q3 (OR = 1.85, 95% CI: 1.39\u20132.48) and Q4 (OR = 2.95, 95% CI: 2.21\u20133.94). For P2hBG\/HbA1c, the fourth quartile (OR = 1.56, 95% CI: 1.17\u20132.08). Subgroup analysis and RCS analysis confirmed a consistent linear association across all subgroups, with no significant non-linearity. The present study demonstrated that NHHR and TG\/HDL-C exhibited significant independent mediating effects in the association between these glycaemic markers and DR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The present study found a positive correlation between SHR, FBG\/HbA1c and P2hBG\/HbA1c with the prevalence of DR in T2DM patients. Furthermore, NHHR and TG\/HDL-C exhibited exploratory mediating effects in these associations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1798444","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:51:13Z","timestamp":1778219473000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Association analysis and exploratory mediation study of the stress-induced hyperglycaemia ratio and glycaemic ratio indices with diabetic retinopathy in patients with type 2 diabetes"],"prefix":"10.3389","volume":"13","author":[{"given":"Deyuan","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongyuan","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of 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