Zhang Yuan, Chen Guanhua, Wang Weimin, Jing Yali
Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China.
Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China.
Front Nutr. 2025 Mar 4;12:1537707. doi: 10.3389/fnut.2025.1537707. eCollection 2025.
Diabetic retinopathy (DR) is associated with abnormal lipid metabolism and inflammation. However, a single lipid or inflammatory parameter cannot accurately predict the prognosis of DR independently, because it is prone to be affected by various confounding factors. This study aimed to explore the relationship between the inflammation-lipid indicator C-reactive protein (CRP)/high-density lipoprotein cholesterol (HDL-C) and DR occurrence in subjects with type 2 diabetes mellitus (T2DM).
This hospital-based retrospective study included 784 T2DM patients. Diabetic retinopathy was diagnosed by nonmydriatic fundus photography and/or fundus examination apparatus. T2DM patients were divided into non-DR and DR groups. Demographics variables, clinical history and serum biochemical indicators of the subjects were collected. We also calculated the CRP/HDL-C ratio. The association between the CRP/HDL-C and DR was assessed using multivariate logistic regression analyses.
A total of 784 participants, 612 without DR and 172 with DR, were included in the final sample analysis. Compared with non-DR participants, the DR diagnostic group had significantly higher CRP/HDL-C (4.03 ± 1.67 vs. 2.66 ± 0.97; < 0.001). Then, the patients were grouped based on the quartiles of CRP/HDL-C, there was a gradual increase in the prevalence of DR was noted in T2DM patients along with the increased quartile of the CRP/HDL-C ratio (Q1: 7.65%; Q2: 15.31%; Q3: 19.90%; Q4: 44.90%; = 0.028). After adjustment for the impact of various covariates, the odds ratio (OR) of the third and fourth vs. the first quartile of CRP/HDL-C were 2.905 (95% confidence interval [CI]: 1.372 ~ 6.152, = 0.005) and 9.938 (95% CI: 4.987 ~ 19.804, < 0.001), respectively. Further, multivariate logistic regression model showed that the CRP/HDL-C ratio (OR 3.176, 95% CI: 1.280 ~ 7.877, = 0.013) was identified as risk factor for DR. Moreover, the area under the curve (AUC) to evaluate the predictive value of CRP/HDL-C for the risk of DR occurrence was 0.752 (95% CI: 0.711 ~ 0.794).
The ratio of C-reactive protein (CRP) to high-density lipoprotein cholesterol (HDL-C) is associated with DR in patients with T2DM, and CRP/HDL-C may be an effective marker to help identify the risk of DR in patients with T2DM.
糖尿病视网膜病变（DR）与脂质代谢异常及炎症相关。然而，单一的脂质或炎症参数无法独立准确预测DR的预后，因为其易受多种混杂因素影响。本研究旨在探讨炎症 - 脂质指标C反应蛋白（CRP）/高密度脂蛋白胆固醇（HDL - C）与2型糖尿病（T2DM）患者DR发生之间的关系。
本基于医院的回顾性研究纳入了784例T2DM患者。通过免散瞳眼底照相和/或眼底检查设备诊断糖尿病视网膜病变。将T2DM患者分为非DR组和DR组。收集受试者的人口统计学变量、临床病史和血清生化指标。我们还计算了CRP/HDL - C比值。采用多因素logistic回归分析评估CRP/HDL - C与DR之间的关联。
最终样本分析共纳入784名参与者，其中612例无DR，172例有DR。与非DR参与者相比，DR诊断组的CRP/HDL - C显著更高（4.03±1.67 vs. 2.66±0.97；<0.001）。然后，根据CRP/HDL - C的四分位数对患者进行分组，随着CRP/HDL - C比值四分位数的增加，T2DM患者中DR的患病率逐渐升高（Q1：7.65%；Q2：15.31%；Q3：19.90%；Q4：44.90%；=0.028）。在调整各种协变量的影响后，CRP/HDL - C第三和第四四分位数与第一四分位数相比的比值比（OR）分别为2.905（95%置信区间[CI]：1.372～6.152，=0.005）和9.938（95%CI：4.987～19.804，<0.001）。此外，多因素logistic回归模型显示CRP/HDL - C比值（OR 3.176，95%CI：1.280～7.877，=0.013）被确定为DR的危险因素。而且，评估CRP/HDL - C对DR发生风险预测价值的曲线下面积（AUC）为0.752（95%CI：0.711～0.794）。
C反应蛋白（CRP）与高密度脂蛋白胆固醇（HDL - C）的比值与T2DM患者的DR相关，且CRP/HDL - C可能是有助于识别T2DM患者DR风险的有效标志物。
