The Value of White Cell Inflammatory Biomarkers as Potential Predictors for Diabetic Retinopathy in Type 2 Diabetes Mellitus (T2DM)

Abstract

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; p = 0.005; 0.376 ± 0.216 vs. 0.269 ± 0.083 and 0.275 ± 0.111, p = 0.001; 754.4 ± 514.4 vs. 551.5 ± 215.1 and 560.3 ± 248.6, p = 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.

The Predictors of Early Treatment Effectiveness of Intravitreal Bevacizumab Application in Patients with Diabetic Macular Edema

“…The NLR, MLR, PLR, and SII did not show significant differences in moderate and severe NPDR in our study, which is in line with other studies [23][24][25]. Zeng et al showed that the NLR, PLR, and MLR were significantly higher in patients with DR compared to patients without DR; however, there was no relationship between the MLR, NLR, or PLR and severity of retinopathy [23].…”

“…Zeng et al showed that the NLR, PLR, and MLR were significantly higher in patients with DR compared to patients without DR; however, there was no relationship between the MLR, NLR, or PLR and severity of retinopathy [23]. According to Dascalu et al, the NLR, MLR, and SII were significantly higher in patients with proliferative diabetic retinopathy compared to those with NPDR or without DR [24]. The aforementioned biomarkers are more related to DME, which was also recently validated in the research by Yanxia et al, who found notable variations in biomarkers in various types of DME [25].…”

The Influence of Acute and Chronic Exercise on Appetite and Appetite Regulation in Patients with Prediabetes or Type 2 Diabetes Mellitus—A Systematic Review

“…If optimally implemented, these effects could further increase the potential of exercise to slow down the progression of T2DM and its complications (e.g., diabetic retinopathy or neuropathy) [ 62 , 63 ].…”

Arteriovenous Length Ratio: A Novel Method for Evaluating Retinal Vasculature Morphology and Its Diagnostic Potential in Eye-Related Diseases

“…Various morphological abnormalities in the retinal vasculature, such as increased artery tortuosity, altered arteriovenous width and ratio (AVR), arteriovenous (AV) nicking, and the onset of macular edema in severe cases, characterize hypertensive retinopathy (HR) [1] and diabetic retinopathy [2]. These abnormalities can lead to reduced visual acuity and an increased risk of stroke later in life, suggesting inflammation in the retinal vasculature.…”