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

• Published in: Biomedicines Vol. 11; no. 8; p. 2106
• Main Authors: 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
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 26.07.2023; MDPI
• Subjects: Biomarkers; Blood; Blood platelets; Cardiovascular disease; Comparative analysis; Creatinine; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetic retinopathy; Inflammation; Kinases; Leukocytes (neutrophilic); Lymphocytes; Medical research; Medicine, Experimental; monocyte-to-lymphocyte ratio (MLR); Monocytes; neutrophil-to-lymphocyte ratio (NLR); Neutrophils; Ophthalmology; Patients; platelet-to-lymphocyte ratio (PLR); Prediction models; Regression analysis; Retina; Retinopathy; Statistical analysis; systemic inflammation index (SII); Type 2 diabetes; Visual impairment; Romania
• ISSN: 2227-9059; 2227-9059
• 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; 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.