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Use of the Monocyte-to-Lymphocyte Ratio to Predict Diabetic Retinopathy.

Yue S, Zhang J, Wu J, Teng W, Liu L, Chen L - Int J Environ Res Public Health (2015)

Bottom Line: The mean PLR and NLR were significantly higher in patients with DR compared with patients without DR (p < 0.01, p = 0.02, respectively).The PLR and NLR are significantly increased in the setting of DR.After correcting for possible confounding factors, the MLR was found to be a risk factor for DR.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, The First Affiliated Hospital of China Medical University, No.155 Nanjing North Street, Heping District, Shenyang 110001, China. yuesong567@163.com.

ABSTRACT

Background: Diabetic retinopathy (DR) is a common complication of type 2 diabetes mellitus (T2DM) and the leading cause of blindness in adults. DR pathogenesis has not been fully elucidated, but inflammation is widely accepted to play an important role. Emerging evidence suggests that the platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and neutrophil-to-lymphocyte ratio (NLR) are novel potential markers of inflammatory responses. The present study aimed to evaluate the associations between DR and the PLR, MLR, and NLR.

Patients and methods: We performed a case-control study involving 247 patients with T2DM. The patients were divided into three groups: 125 control subjects with T2DM, 63 diabetic subjects with non-proliferative diabetic retinopathy (NPDR), and 59 patients with proliferative diabetic retinopathy (PDR).

Results: The mean PLR and NLR were significantly higher in patients with DR compared with patients without DR (p < 0.01, p = 0.02, respectively). The mean MLR in the NPDR group was higher than that of patients without DR, but there were no significant differences among the three groups (p = 0.07). Logistic regression showed that the MLR was an independent risk factor for DR (odds ratio [OR]: 54.574, 95% confidence interval [CI]: 2.708-1099.907). Based on the receiver operating characteristic (ROC) curve, use of the MLR as an indicator for DR diagnosis was projected to be 2.25, and yielded a sensitivity and specificity of 47.1% and 69.6%, respectively, with an area under the curve of 0.581 (95% CI: 0.510-0.653).

Conclusions: The PLR and NLR are significantly increased in the setting of DR. After correcting for possible confounding factors, the MLR was found to be a risk factor for DR. Although the MLR may be pathophysiologically and clinically relevant in DR, its predictive ability was limited.

No MeSH data available.


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Receiver–operating characteristics (ROC) curve analysis for monocyte to lymphocyte ratio as a predictor of the severity of diabetic retinopathy.
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ijerph-12-10009-f001: Receiver–operating characteristics (ROC) curve analysis for monocyte to lymphocyte ratio as a predictor of the severity of diabetic retinopathy.

Mentions: The patients were divided into three groups: 125 control subjects with T2DM, 62 diabetic subjects with NPDR, and 59 patients with PDR. The baseline characteristics of all 246 subjects are shown in Table 1. We observed significant differences for DM duration, SBP, DBP, HbA1c, TC, HDL-C, LDL-C, PLT, NLR, PLR, and MLR (p < 0.05). DR patients were divided into two groups based on severity (NPDR and PDR). The results are shown in Table 2. The PLR and NLR were significantly higher in patients with DR compared with patients without DR (p < 0.01 and p = 0.02, respectively). The mean MLR of patients with NPDR were higher than those of patients without DR (median [IQR] 0.22[0.30–0.14] vs. 0.18[0.24–0.13]), but there were no statistical differences among the three groups (p = 0.07). In addition, retinopathy severity was not associated with increased NLR, PLR, or MLR. Logistic regression analysis revealed that independent risk factors for DR were DM duration, SBP, MLR, TG, HDL-C, and PLT (Table 3). Figure 1 shows that as an independent risk factor for DR, the cut-off value of MLR was 2.25, and the sensitivity and specificity of the MLR for DR diagnosis were 47.1% and 69.6%, respectively, with an area under the curve at 0.581 (95% confidence interval (CI): 0.510–0.653). The positive predictive value (95%CI), negative predictive value (95%CI) for MLR for DR diagnosis were 59.82% (49.25% to 69.75%) and 57.80% (49.5% to 65.78%), respectively.


Use of the Monocyte-to-Lymphocyte Ratio to Predict Diabetic Retinopathy.

Yue S, Zhang J, Wu J, Teng W, Liu L, Chen L - Int J Environ Res Public Health (2015)

Receiver–operating characteristics (ROC) curve analysis for monocyte to lymphocyte ratio as a predictor of the severity of diabetic retinopathy.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4555325&req=5

ijerph-12-10009-f001: Receiver–operating characteristics (ROC) curve analysis for monocyte to lymphocyte ratio as a predictor of the severity of diabetic retinopathy.
Mentions: The patients were divided into three groups: 125 control subjects with T2DM, 62 diabetic subjects with NPDR, and 59 patients with PDR. The baseline characteristics of all 246 subjects are shown in Table 1. We observed significant differences for DM duration, SBP, DBP, HbA1c, TC, HDL-C, LDL-C, PLT, NLR, PLR, and MLR (p < 0.05). DR patients were divided into two groups based on severity (NPDR and PDR). The results are shown in Table 2. The PLR and NLR were significantly higher in patients with DR compared with patients without DR (p < 0.01 and p = 0.02, respectively). The mean MLR of patients with NPDR were higher than those of patients without DR (median [IQR] 0.22[0.30–0.14] vs. 0.18[0.24–0.13]), but there were no statistical differences among the three groups (p = 0.07). In addition, retinopathy severity was not associated with increased NLR, PLR, or MLR. Logistic regression analysis revealed that independent risk factors for DR were DM duration, SBP, MLR, TG, HDL-C, and PLT (Table 3). Figure 1 shows that as an independent risk factor for DR, the cut-off value of MLR was 2.25, and the sensitivity and specificity of the MLR for DR diagnosis were 47.1% and 69.6%, respectively, with an area under the curve at 0.581 (95% confidence interval (CI): 0.510–0.653). The positive predictive value (95%CI), negative predictive value (95%CI) for MLR for DR diagnosis were 59.82% (49.25% to 69.75%) and 57.80% (49.5% to 65.78%), respectively.

Bottom Line: The mean PLR and NLR were significantly higher in patients with DR compared with patients without DR (p < 0.01, p = 0.02, respectively).The PLR and NLR are significantly increased in the setting of DR.After correcting for possible confounding factors, the MLR was found to be a risk factor for DR.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, The First Affiliated Hospital of China Medical University, No.155 Nanjing North Street, Heping District, Shenyang 110001, China. yuesong567@163.com.

ABSTRACT

Background: Diabetic retinopathy (DR) is a common complication of type 2 diabetes mellitus (T2DM) and the leading cause of blindness in adults. DR pathogenesis has not been fully elucidated, but inflammation is widely accepted to play an important role. Emerging evidence suggests that the platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and neutrophil-to-lymphocyte ratio (NLR) are novel potential markers of inflammatory responses. The present study aimed to evaluate the associations between DR and the PLR, MLR, and NLR.

Patients and methods: We performed a case-control study involving 247 patients with T2DM. The patients were divided into three groups: 125 control subjects with T2DM, 63 diabetic subjects with non-proliferative diabetic retinopathy (NPDR), and 59 patients with proliferative diabetic retinopathy (PDR).

Results: The mean PLR and NLR were significantly higher in patients with DR compared with patients without DR (p < 0.01, p = 0.02, respectively). The mean MLR in the NPDR group was higher than that of patients without DR, but there were no significant differences among the three groups (p = 0.07). Logistic regression showed that the MLR was an independent risk factor for DR (odds ratio [OR]: 54.574, 95% confidence interval [CI]: 2.708-1099.907). Based on the receiver operating characteristic (ROC) curve, use of the MLR as an indicator for DR diagnosis was projected to be 2.25, and yielded a sensitivity and specificity of 47.1% and 69.6%, respectively, with an area under the curve of 0.581 (95% CI: 0.510-0.653).

Conclusions: The PLR and NLR are significantly increased in the setting of DR. After correcting for possible confounding factors, the MLR was found to be a risk factor for DR. Although the MLR may be pathophysiologically and clinically relevant in DR, its predictive ability was limited.

No MeSH data available.


Related in: MedlinePlus