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Yang P, Xu W, Liu L, Yang G. Association of lactate dehydrogenase and diabetic retinopathy in US adults with diabetes mellitus. J Diabetes 2024; 16:e13476. [PMID: 37746907 PMCID: PMC10809301 DOI: 10.1111/1753-0407.13476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/23/2023] [Accepted: 09/03/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVES The purpose of our investigation is to evaluate the level of relationship between lactate dehydrogenase (LDH) and the occurrence of diabetic retinopathy (DR) in adults with diabetes mellitus (DM). METHODS The investigation involved an analysis of five sectional data cycles acquired from the National Health and Nutrition Examination Survey from 2009 to 2018. The present study involved the selection of DM samples from a complex multistage probability sample. These samples were subsequently classified into two distinct groups, namely the No DR (NDR) and DR groups. The present study comprehensively investigated the biological and social risk factors associated with DR. The biological factors examined in this investigation included blood pressure, blood routine, hemoglobin A1c, blood glucose, and comorbidities. The social dimensions encompass education and sex. RESULTS After considering all factors, multivariate regression models indicated a significant relationship between DR and increased LDH (adjusted odds ratio = 1.007, 95% confidence interval: 1.003-1.011). The subgroup analysis revealed that the effect size of LDH on the existence of DR in the subgroups remained consistent, as indicated by all p values greater than .05. A statistically significant relationship was identified between elevated LDH levels > 134 U/L and a raised risk of DR in people with DM. CONCLUSION LDH concentrations were connected with an increased prevalence of DR in participants with DM. Our study highlights that patients with LDH > 134 U/L are distinguishably related to DM complicated by DR. DR is more common in diabetic individuals with coronary heart disease.
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Affiliation(s)
- Ping Yang
- Department of Critical Care MedicineSecond Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Weiwei Xu
- Department of Endocrinology and MetabolismSecond Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Ling Liu
- Department of OphthalmologyChongqing University Central Hospital, Chongqing Emergency Medical CenterChongqingChina
| | - Gangyi Yang
- Department of Endocrinology and MetabolismSecond Affiliated Hospital of Chongqing Medical UniversityChongqingChina
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Evaluation of Lymphocyte-to-Monocyte Ratio and Mean Platelet Volume-to-Platelet Ratio in Rhegmatogenous Retinal Detachment. J Ophthalmol 2022; 2022:9127745. [PMID: 36157678 PMCID: PMC9507743 DOI: 10.1155/2022/9127745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose To assess the predictive value of inflammatory blood biomarkers in rhegmatogenous retinal detachment (RRD) patients and its correlation with proliferative retinopathy (PVR) grade. Methods 82 RRD patients and 1 : 1 age- and gender-randomly matched cataract patients as the control group were included. The clinical features and laboratory parameters of all participants were collected and recorded, and the comprehensive index of inflammatory blood and its correlation with PVR were calculated. Results Monocytes and monocyte-to-high-density lipoprotein ratio (MHR) were significantly lower (P=0.005, P=0.044), while mean platelet volume (MPV), lymphocyte-to-monocyte ratio (LMR), and MPV-to-platelet ratio (MPR) were significantly higher in RRD patients as compared with the control group (P=0.013, P=0.019, P=0.037). LMR and MPR might be the predictors of RRD. The receiver operating characteristics analysis showed that the values of MPV, LMR, and MPR in RRD patients were 0.612, 0.606, and 0.594, respectively. PVR grade was not associated with inflammatory blood biomarkers. Conclusion The increase in MPV, LMR, and MPR were associated with increased odds of RRD. LMR and MPR may be useful as inexpensive and effortless biomarkers for assessing the occurrence of RRD.
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He X, Qi S, Zhang X, Pan J. The relationship between the neutrophil-to-lymphocyte ratio and diabetic retinopathy in adults from the United States: results from the National Health and nutrition examination survey. BMC Ophthalmol 2022; 22:346. [PMID: 35978314 PMCID: PMC9382734 DOI: 10.1186/s12886-022-02571-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 08/10/2022] [Indexed: 11/22/2022] Open
Abstract
Background Diabetic retinopathy (DR) is a common complication of diabetes mellitus (DM). Systemic inflammation is intimately associated with DR. The neutrophil-to-lymphocyte ratio (NLR) index is a relatively new indicator of inflammation. Methods This cross-sectional study was carried out among adults with DM based on the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2016. NLR was presented as absolute neutrophil counts/ absolute lymphocyte counts. The relationship of NLR levels to DR was analyzed using multivariable logistic regression. Results There were 2772 eligible subjects extracted from the NHANES. In the multivariate analysis, NLR was related to the risk of DR after adjustment for potential confounders. The association between NLR levels and DR was nonlinear, with an inflection point of 4.778. Compared with the baseline values, NLR was not statistically significant on the right side of the inflection point (1.000, 0.914 to 1.094, 0.9974) but was positively associated with DR on the left side (1.236, 1.132 to 1.349, < 0.0001). Conclusions NLR reflects systemic inflammation that may increase the risk of DR. NLR positively correlates with DR when its value is less than 4.778.
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Affiliation(s)
- Xiaojie He
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shanshan Qi
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xi Zhang
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jiandong Pan
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Salah NY, Radwan N, Atif HM. Leukocytic dysregulation in children with type 1 diabetes: relation to diabetic vascular complications. Diabetol Int 2022; 13:538-547. [PMID: 35693992 PMCID: PMC9174407 DOI: 10.1007/s13340-021-00568-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 12/26/2021] [Indexed: 01/09/2023]
Abstract
Background Growing evidences highlight the role of the innate immune response in the pathogenesis of type 1 diabetes (T1D) vascular complications. Neutrophil lymphocytic ratio (NLR) and platelet lymphocytic ratio (PLR) are inexpensive but novel markers of chronic inflammation might have prognostic value in children with T1D. Aim To study NLR and PLR levels in children with T1D in comparison to matched controls and correlate them with fraction-C of glycosylated hemoglobin (HbA1C) and micro-vascular complications. Methodology Hundred children with T1D were compared to 100 matched healthy controls. History included diabetes duration, insulin dose and frequency of hypoglycemic attacks. Fundus examination and the simple rapid neuropathy disability score were done. HbA1C, fasting lipids, urinary albumin excretion and complete blood count were measured with assessment of NLR and PLR. Results NLR was significantly higher (p = 0.008) and PLR was significantly lower (p = 0.007) in children with T1D than controls. NLR was positively correlated while PLR was negatively correlated with HbA1C, diabetes duration, fasting cholesterol, triglycerides and LDL. NLR was significantly higher (p < 0.001) and PLR was significantly lower (p = 0.005) in children with microvascular complications than those without. Moreover, multivariate logistic regression revealed that microvascular complications were independently associated with NLR (p = 0.013) and PLR (p = 0.004). Conclusion Children with T1D had significantly higher NLR and lower PLR compared to controls. These changes were more evident in those with diabetic microvascular complications than those without. Furthermore, NLR was positively correlated and PLR was negatively correlated to HbA1C, diabetes duration and hyperlipidemia. Hence, NLR and PLR can be a potential indicator for the risk of development of diabetic microvascular complications in children with T1D.
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Affiliation(s)
- Nouran Yousef Salah
- grid.7269.a0000 0004 0621 1570Pediatrics Department, Pediatric and Adolescents Diabetes Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nesrine Radwan
- grid.7269.a0000 0004 0621 1570Pediatrics Department, Allergy and Immunology Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Heba Mohamed Atif
- grid.7269.a0000 0004 0621 1570Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Zeng J, Chen M, Feng Q, Wan H, Wang J, Yang F, Cao H. The Platelet-to-Lymphocyte Ratio Predicts Diabetic Retinopathy in Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes 2022; 15:3617-3626. [PMID: 36444389 PMCID: PMC9700435 DOI: 10.2147/dmso.s378284] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 11/15/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION As a severe and specific neurovascular complication of type 2 diabetes mellitus (T2DM), diabetic retinopathy (DR) remains the leading cause of vision loss and preventable blindness in adults aged 20 to 74. The pathogenesis of DR is not completely understood, however, studies indicate that chronic inflammation plays a significant role. Emerging evidence suggests that the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and the monocyte-to-lymphocyte ratio (MLR) are novel potential inflammatory response markers. The purpose of this study was to investigate the relationships between the NLR, PLR, MLR, and DR. PATIENTS AND METHODS 290 patients who had been diagnosed with T2DM participated in the study. Patients were categorized into three groups: 142 control subjects with T2DM, 124 subjects with nonproliferative diabetic retinopathy (NPDR), and 24 patients with proliferative diabetic retinopathy (PDR). Characteristics, laboratory data, as well as NLR, PLR and MLR levels of the study groups were compared. RESULTS In patients with DR, the median NLR, PLR, and MLR were significantly higher than in patients without DR (p = 0.012, p < 0.001, and p = 0.043, respectively). In the post hoc analysis, there was no correlation between the severity of retinopathy and the increase in NLR or PLR. Multiple logistic regression revealed that the PLR was an independent risk factor for DR (odds ratio [OR]: 1.020, 95% confidence interval [CI]: 1.010-1.029 p = 0.026). Based on the receiver operating characteristic (ROC) curve, the cutoff value of PLR as an indicator for diagnosing DR was estimated to be 129.65, with a sensitivity and specificity of 53.4% and 76.1%, respectively, and an area under the curve of 0.668 (95% CI: 0.605-0.730, p < 0.001). CONCLUSION Our findings suggest that PLR may be an independent risk factor for evaluating DR in type 2 diabetes patients.
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Affiliation(s)
- Jing Zeng
- Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Endocrinology and Metabolism, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, People’s Republic of China
| | - Min Chen
- Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Endocrinology and Metabolism, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, People’s Republic of China
| | - Qiu Feng
- Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Endocrinology and Metabolism, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, People’s Republic of China
| | - Haiyan Wan
- Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Endocrinology and Metabolism, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, People’s Republic of China
| | - Jianbo Wang
- Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Medical Record, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, People’s Republic of China
| | - Fan Yang
- Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Endocrinology and Metabolism, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, People’s Republic of China
| | - Hongyi Cao
- Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Endocrinology and Metabolism, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, People’s Republic of China
- Correspondence: Hongyi Cao; Fan Yang, Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Endocrinology and Metabolism, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), No. 33, Mashi Street, Wenjiang District, Chengdu, Sichuan, 611130, People’s Republic of China, Tel +86 13730683979, Fax +86 028-82713097, Email ;
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Mohamed-Noriega K, Treviño-Herrera AB, Mohamed-Noriega J, Velasco-Sepúlveda BH, Martínez-Pacheco VA, Guevara-Villarreal DA, Rodríguez-Medellín DL, Sepúlveda-Salinas AG, Villarreal-Méndez G, González-Cortés JH, Elizondo-Omaña RE, Guzmán-López S, Mohamed-Hamsho J. Relationship of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratio With Visual Acuity After Surgical Repair of Open Globe Injury. Front Med (Lausanne) 2021; 8:697585. [PMID: 34881251 PMCID: PMC8645644 DOI: 10.3389/fmed.2021.697585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 10/25/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose: To assess the relationship and prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with poor final best-corrected visual acuity (BCVA) after surgical repair of open globe injuries (OGI) in adults. Design: Retrospective analysis of data from an ongoing prospective cohort of consecutive patients. Methods: In a tertiary university hospital, 197 eyes of 197 patients were included between 2013 and 2017. NLR and PLR were obtained from pre-operative blood tests to analyze its relationship with poor final BCVA. Results: Severe visual impairment (SVI) was defined as ≤20/200, and was observed in 96 (48.7%) patients after surgical repair of OGI. SVI patients had higher NLR (7.4 ± 6.6 vs. 4.0 ± 3.2, p < 0.001), and PLR (167 ± 92 vs. 139 ± 64; p = 0.021) than non-SVI. NLR ≥ 3.47 and PLR ≥ 112.2 were the best cut-off values for SVI, were univariate risk factors for SVI, and had sensitivity: 69.0, 71.4, and specificity: 63.6, 44.8, respectively. In multivariate analysis, only OTS, athalamia, and hyphema remained as risk factors. NLR had significant correlation with ocular trauma score (OTS) (r = −0.389, p < 0.001) and final BCVA (r = 0.345, p < 0.001). Limitations: Simultaneous trauma in other parts of the body that could influence the laboratory findings. Conclusion: Patients with SVI after a repaired OGI had increased pre-operative NLR and PLR levels. High NLR and PLR are risk factors for SVI in univariate analysis. It is confirmed that low OTS is a risk factor for SVI. High NLR and PLR could be used as a prognostic tool to identify patients at higher risk for SVI after repair of OGI.
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Affiliation(s)
- Karim Mohamed-Noriega
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Alan B Treviño-Herrera
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Jibran Mohamed-Noriega
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Braulio H Velasco-Sepúlveda
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Víctor A Martínez-Pacheco
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Dante A Guevara-Villarreal
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Delia L Rodríguez-Medellín
- Department of Human Anatomy, Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Anna G Sepúlveda-Salinas
- Department of Human Anatomy, Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Gerardo Villarreal-Méndez
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Jesús H González-Cortés
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Rodrigo E Elizondo-Omaña
- Department of Human Anatomy, Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Santos Guzmán-López
- Department of Human Anatomy, Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
| | - Jesús Mohamed-Hamsho
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León, Monterrey, Mexico
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Zhang P, Xue WW, Huang XB, Xu Y, Lu LN, Zheng KR, Zou HD. Prevalence and risk factors of diabetic retinopathy in patients with type 2 diabetes in Shanghai. Int J Ophthalmol 2021; 14:1066-1072. [PMID: 34282393 DOI: 10.18240/ijo.2021.07.16] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 02/18/2021] [Indexed: 01/02/2023] Open
Abstract
AIM To investigate the prevalence of diabetic retinopathy (DR) in residents of Shanghai and analyze the risk factors of DR. METHODS This study involved 7233 patients with diabetes in 2016. The demographic data of the participants were collected using a questionnaire survey. Physical examination, laboratory tests, and ophthalmological examinations were conducted. Two professional ophthalmologists diagnosed and graded DR by fundus examination and then combined the results with fundus images. The unconditional multivariate Logistic regression analysis was used to determine the risk factors. RESULTS In total, 6978 patients with type 2 diabetes in Shanghai with a mean age of 68.33±8.40y were recruited, including 2975 males (42.6%) and 4003 females (57.4%). Overall, 1184 patients were diagnosed with DR, with a prevalence rate of 16.97%. Regression analysis showed that duration of diabetes (OR 1.061, 95%CI 1.049-1.073), high systolic blood pressure (SBP; OR 1.071, 95%CI 1.037-1.106), increased glycosylated hemoglobin level (OR 1.234, 95%CI 1.162-1.311), high blood glucose level (OR 1.061, 95%CI 1.023-1.099), increased neutrophil-to-lymphocyte ratio (NLR; OR 1.132, 95%CI 1.053-1.217) and mean platelet volume (MPV; OR 1.077, 95%CI 1.016-1.142) were risk factors of DR. Conversely, hematocrit (HCT; OR 0.971, 95%CI 0.954-0.988) and mean corpuscular volume (MCV; OR 0.980, 95%CI 0.965-0.994) were protective factors. CONCLUSION The prevalence rate of DR in Shanghai is 16.97%. The duration of diabetes, high SBP, increased glycosylated hemoglobin, NLR, and MPV were determined as risk factors of DR.
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Affiliation(s)
- Pei Zhang
- Department of Ophthalmology, Shanghai Gonghui Hospital, Shanghai 200041, China
| | - Wen-Wen Xue
- Department of Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai 200040, China
| | - Xiao-Bo Huang
- Department of Ophthalmology, the Second Affiliated Hospital of Nantong University, Nantong 226000, Jiangsu Province, China
| | - Yi Xu
- Department of Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai 200040, China
| | - Li-Na Lu
- Department of Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai 200040, China
| | - Kai-Rong Zheng
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - Hai-Dong Zou
- Department of Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai 200040, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
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Baek SU, Park MS, Cho BJ, Park IW, Kwon S. Risk factors associated with progression of diabetic retinopathy in eyes treated with panretinal photocoagulation. Sci Rep 2021; 11:13850. [PMID: 34226638 PMCID: PMC8257738 DOI: 10.1038/s41598-021-93384-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/24/2021] [Indexed: 11/18/2022] Open
Abstract
Uncontrolled diabetes has been associated with progression of diabetic retinopathy (DR) in several studies. Therefore, we aimed to investigate systemic and ophthalmic factors related to worsening of DR even after completion of panretinal photocoagulation (PRP). We retrospectively reviewed DR patients who had completed PRP in at least one eye with a 3-year follow-up. A total of 243 eyes of 243 subjects (mean age 52.6 ± 11.6 years) were enrolled. Among them, 52 patients (21.4%) showed progression of DR after PRP (progression group), and the other 191 (78.6%) patients had stable DR (non-progression group). The progression group had higher proportion of proliferative DR (P = 0.019); lower baseline visual acuity (P < 0.001); and higher platelet count (P = 0.048), hemoglobin (P = 0.044), and hematocrit, (P = 0.042) than the non-progression group. In the multivariate logistic regression analysis for progression of DR, baseline visual acuity (HR: 0.053, P < 0.001) and platelet count (HR: 1.215, P = 0.031) were identified as risk factors for progression. Consequently, we propose that patients with low visual acuity or high platelet count are more likely to have progressive DR despite PRP and require careful observation. Also, the evaluation of hemorheological factors including platelet counts before PRP can be considered useful in predicting the prognosis of DR.
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Affiliation(s)
- Sung Uk Baek
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 22, Gwanpyeong‑ro 170beon‑gil, Dongan-gu, Anyang, 14068, Republic of Korea
| | - Min Seon Park
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 22, Gwanpyeong‑ro 170beon‑gil, Dongan-gu, Anyang, 14068, Republic of Korea
| | - Bum-Joo Cho
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 22, Gwanpyeong‑ro 170beon‑gil, Dongan-gu, Anyang, 14068, Republic of Korea
| | - In Won Park
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 22, Gwanpyeong‑ro 170beon‑gil, Dongan-gu, Anyang, 14068, Republic of Korea
| | - Soonil Kwon
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 22, Gwanpyeong‑ro 170beon‑gil, Dongan-gu, Anyang, 14068, Republic of Korea.
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Huang Q, Wu H, Wo M, Ma J, Song Y, Fei X. Clinical and predictive significance of Plasma Fibrinogen Concentrations combined Monocyte-lymphocyte ratio in patients with Diabetic Retinopathy. Int J Med Sci 2021; 18:1390-1398. [PMID: 33628095 PMCID: PMC7893560 DOI: 10.7150/ijms.51533] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 01/04/2021] [Indexed: 11/05/2022] Open
Abstract
Diabetic retinopathy (DR) is one of the most common causes of blindness and visual impairment. Therefore, early prediction of its occurrence and progression is important. This study aimed to assess the clinical and predictive significance of plasma fibrinogen concentrations combined monocyte-lymphocyte ratio (FC-MLR) in patients with DR. A total of 307 patients with type 2 diabetes (T2D) were enrolled. Plasma fibrinogen concentrations and peripheral white blood cells were measured, and MLR was calculated, and the associations of FC-MLR with DR and severity of disease were assessed. Regression analysis and receiver operating characteristic (ROC) curves were performed to evaluate the risk factors and predictive power of FC-MLR for DR and severity of disease, respectively. DR patients showed higher fibrinogen concentrations and a higher MLR than did T2D patients without complications (P<0.01); Moreover, DR patients in proliferative stage also showed higher fibrinogen concentrations and a higher MLR than did those in non-proliferative stage (P<0.01). FC-MLR was closely associated with occurrence and severity of DR (P<0.01), and was an independent risk factor for them (OR=6.123, 95%CI: 3.122-17.102; and 7.932, 95%CI: 4.315-16.671, respectively; P<0.001). The predictive sensitivity and specificity for DR and severity of disease were 0.86 and 0.68, and 0.85 and 0.73, respectively. The study suggests that FC-MLR may be used as a predictor for the risk and progression of diabetic retinopathy.
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Affiliation(s)
- Qinghua Huang
- Department of Endocrinology, Zhejiang Provincial People's Hospital, and People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China.,Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Hui Wu
- Department of Endocrinology, Zhejiang Provincial People's Hospital, and People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China.,Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Mingyi Wo
- Center for Laboratory Medicine, Zhejiang Provincial People's Hospital, and People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Jiangbo Ma
- Department of Endocrinology, Zhejiang Provincial People's Hospital, and People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China.,Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yingxiang Song
- Department of Endocrinology, Zhejiang Provincial People's Hospital, and People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China.,Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Xianming Fei
- Center for Laboratory Medicine, Zhejiang Provincial People's Hospital, and People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China
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Li W, Ren X, Zhang L. Clinical efficacy of atorvastatin calcium combined with aspirin in patients with acute ischemic stroke and effect on neutrophils, lymphocytes and IL-33. Exp Ther Med 2020; 20:1277-1284. [PMID: 32765667 PMCID: PMC7388513 DOI: 10.3892/etm.2020.8820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 12/03/2019] [Indexed: 11/06/2022] Open
Abstract
Clinical efficacy of atorvastatin calcium combined with aspirin in patients with acute ischemic stroke (AIS) and its effect on neutrophils to lymphocytes ratio (NLR) and interleukin-33 (IL-33) were investigated. In total, 108 patients with AIS in Luoyang Central Hospital Affiliated to Zhengzhou University from April 2016 to October 2017 were selected. There were 56 cases treated with atorvastatin calcium combined with aspirin as the observation group, and 52 cases were treated with aspirin alone as the control group. The clinical effect was observed. The NLR and IL-33 levels were measured by routine blood test and enzyme linked immunosorbent assay (ELISA) before and after treatment. The scores of the National Institutes of Health Stroke scale (NIHSS) and the occurrence of complications were collected before and after treatment in the two groups. Modified Rankin Scale (MRS) was used to evaluate the curative effect. Score ≤2 points is effective in the treatment. Pearson's analysis was used to analyze the correlation between NLR, IL-33 and NIHSS score. The total hospitalization time and 1 year survival rate were compared. The total effective rate of treatment in the observation group was higher than that in the control group (P<0.05). There was no difference in NLR and IL-33 levels between the two groups before treatment (P>0.05). After treatment, the NLR in the observation group was significantly lower than that in the control group (P<0.05). After treatment, the NIHSS score, the total number of complications and the total hospitalization time in the observation group were significantly lower than those in the control group (P<0.05). Pearson's analysis showed a positive correlation between NLR and NIHSS score (r=0.681, P<0.001), and a negative correlation between IL-33 and NIHSS score (r=-0.708, P<0.001). In conclusion, atorvastatin calcium combined with aspirin has a better effective rate in the treatment of acute ischemic stroke than aspirin alone. The combination can better reduce the NLR, increase the expression level of IL-33 in serum, reduce the occurrence of complications and hospitalization time, and increase the survival rate of patients.
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Affiliation(s)
- Wanhui Li
- Department of Rehabilitation, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan 471009, P.R. China
| | - Xiangyang Ren
- Department of Neurology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan 471009, P.R. China
| | - Li Zhang
- Department of Neurology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, Henan 471009, P.R. China
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Wang JR, Chen Z, Yang K, Yang HJ, Tao WY, Li YP, Jiang ZJ, Bai CF, Yin YC, Duan JM, Zhou YY, Geng XQ, Yang Y. Association between neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and diabetic retinopathy among diabetic patients without a related family history. Diabetol Metab Syndr 2020; 12:55. [PMID: 32636938 PMCID: PMC7331251 DOI: 10.1186/s13098-020-00562-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 06/24/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Diabetic retinopathy (DR) is a specific neurovascular complication of diabetes mellitus (DM). Clinically, family history is a widely recognized risk factor for DR, assisting diagnosis and risk strata. However, among a great amount of DR patients without hereditary history like hypertension and diabetes, direct and simple risk factors to assist clinical decisions are still required. Herein, we intend to investigate the associated risk factors for these DR patients based on systemic inflammatory response indexes, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). METHODS We consecutively enrolled 1030 patients with a definite diagnosis of type 2 diabetes mellitus (T2DM) from the endocrinology department of the Second hospital of People in Yun Nan. Based on funduscopy and family history checking, we excluded patients with a family history of hypertension and diabetes and finally enrolled 264 patients with DR and 206 patients with non-diabetic retinopathy (NDR). Through correlation analysis, univariate and multivariate regression, we further explore the association between NLR, PLR, and DR. On top of that, we investigate the effect of NLR and PLR on risk reclassification of DR. RESULTS Compared with NDR patients, NLR and PLR levels are significantly higher among DR patients (NLR: 2.36 ± 1.16 in DR group versus 1.97 ± 1.06 in NDR group, p < 0.001; PLR: 11.62 ± 4.55 in DR group versus10.56 ± 4.45 in NDR group, p = 0.012). According to univariate analysis, NLR and PLR add risks to DR. After fully adjusting co-founders, NLR, as both continuous and categorical variate, remains an independent risk factor for DR (OR (95%CI): 1.37 (1.06, 1.78) P = 0.018). And though PLR was not independently associated with DR as a continuous variable (OR (95%CI) 1.05 (0.99, 1.11) p = 0.135), the highest quantile of PLR add two-fold increased risk (OR (95%CI) 2.20 (1.05, 4.59) p = 0.037) in the fully adjusted model for DR. In addition, addition of PLR and NLR to the established factor hemoglobin (Hb) improved the discriminability of the model and assisted the reclassification of DR. After combining PLR and NLR the Area under curve (AUC) of Hb based model raised from 0.76 to 0.78, with a category-free net reclassification improvement (NRI) of 0.532 (p < 0.001) and integrated discrimination improvement (IDI) of 0.029 (p < 0.001). CONCLUSIONS Systemic inflammatory response indexes NLR and PLR were associated with the presence of DR among patients without associated family history and contributed to improvements in reclassification of DR in addition to Hb.
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Affiliation(s)
- Jin-Rui Wang
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
| | - Zhongli Chen
- Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 200001 Shanghai, China
| | - Ke Yang
- Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 200001 Shanghai, China
| | - Hui-Jun Yang
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
| | - Wen-Yu Tao
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
| | - Yi-Ping Li
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
| | - Ze-Jia Jiang
- The Second People’s Hospital of Qujing City, Yunnan Qujing, 655000 China
| | - Chao-Fang Bai
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
| | - Yue-Chuan Yin
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
| | - Jian-Mei Duan
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
| | - Yuan-Yuan Zhou
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
| | - Xin-Qian Geng
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
| | - Ying Yang
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
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