Dascalu Ana Maria, Serban Dragos, Tanasescu Denisa, Vancea Geta, Cristea Bogdan Mihai, Stana Daniela, Nicolae Vanessa Andrada, Serboiu Crenguta, Tribus Laura Carina, Tudor Corneliu, Georgescu Adriana, Tudosie Mihail Silviu, Costea Daniel Ovidiu, Bratu Dan Georgian
Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania.
Ophthalmology Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania.
Biomedicines. 2023 Jul 26;11(8):2106. doi: 10.3390/biomedicines11082106.
The pathogenesis of diabetic retinopathy is still challenging, with recent evidence proving the key role of inflammation in the damage of the retinal neurovascular unit. This study aims to investigate the predictive value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic inflammation index (SII) for diabetic retinopathy (DR) and its severity. We performed a retrospective study on 129 T2DM patients, divided into three groups: without retinopathy (NDR), non-proliferative DR (NPDR), and proliferative DR (PDR). NLR, MLR, and SII were significantly higher in the PDR group when compared to NDR and NPDR (3.2 ± 1.6 vs. 2.4 ± 0.9 and 2.4 ± 1.1; = 0.005; 0.376 ± 0.216 vs. 0.269 ± 0.083 and 0.275 ± 0.111, = 0.001; 754.4 ± 514.4 vs. 551.5 ± 215.1 and 560.3 ± 248.6, = 0.013, respectively). PDR was correlated with serum creatinine (OR: 2.551), NLR (OR: 1.645), MPV (OR: 1.41), and duration of diabetes (OR: 1.301). Logistic regression analysis identified three predictive models with very good discrimination power for PDR (AUC ROC of 0.803, 0.809, and 0.830, respectively): combining duration of diabetes with NLR, MLR, and, respectively, PLR, MPV, and serum creatinine. NLR, MPV, SII, and LMR were associated with PDR and could be useful when integrated into comprehensive risk prediction models.
糖尿病视网膜病变的发病机制仍然具有挑战性，最近有证据证明炎症在视网膜神经血管单元损伤中起关键作用。本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）及全身炎症指数（SII）对糖尿病视网膜病变（DR）及其严重程度的预测价值。我们对129例2型糖尿病患者进行了一项回顾性研究，将其分为三组：无视网膜病变（NDR）组、非增殖性DR（NPDR）组和增殖性DR（PDR）组。与NDR组和NPDR组相比，PDR组的NLR、MLR和SII显著更高（分别为3.2±1.6 vs. 2.4±0.9和2.4±1.1；P = 0.005；0.376±0.216 vs. 0.269±0.083和0.275±0.111，P = 0.001；754.4±514.4 vs. 551.5±215.1和560.3±248.6，P = 0.013）。PDR与血清肌酐（比值比：2.551）、NLR（比值比：1.645）、平均血小板体积（MPV，比值比：1.41）及糖尿病病程（比值比：1.301）相关。逻辑回归分析确定了三个对PDR具有非常好区分能力的预测模型（受试者工作特征曲线下面积分别为0.803、0.809和0.830）：分别将糖尿病病程与NLR、MLR以及PLR、MPV和血清肌酐相结合。NLR、MPV、SII和LMR与PDR相关，当纳入综合风险预测模型时可能有用。
