Aims: Diabetic retinopathy (DR) is one of the most prevalent complications, which causes visual impairment and vision loss in diabetic patients. It has been demonstrated that inflammation plays an important role in DR. Accumulating evidence suggests that the neutrophil-to-lymphocyte ratio (NLR) is a novel potential marker for determining the inflammatory state. We aimed to evaluate the correlation between the NLR and DR.

Methods: We performed a cross-sectional study involving 1658 patients with type 2 diabetic mellitus (T2DM) at the Third Affiliated Hospital of Sun Yat-sen University from January 2016 to December 2018. All these subjects underwent stereo fundus photography taken by a 45° Non-Mydriatic Fundus Camera (CR6-45NM, Canon, Tokyo, Japan) through undilated pupils, and physical examinations including body mass index (BMI), systolic and diastolic blood pressures (SBP and DBP). Laboratory tests were also performed to determine the levels of fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), serum creatinine (Scr), blood urea nitrogen (BUN), and glycosylated hemoglobin A1c (HbA1c). The NLR was calculated based on the absolute numbers of neutrophils and lymphocytes.

Results: 214 of the patients had DR. The age, DM duration, NLR, SBP were significantly higher in patients with DR compared with patients without DR (p < 0.01). After the adjustments by multivariable analyses, the NLR was still significantly associated with DR (P=0.048, OR=1.088, 95% CI=1.001-1.182).

Conclusion: Our finding reveals that higher NLR values are a reliable biomarker for the occurrence of DR.


M. Li: None. X. Tang: None. Y. Tan: None. Y. Nie: None. H. Li: None. Y. Chen: None.


Research and Development Plans in Key Areas of Guangdong Province (2019B020227003); National Natural Science Foundation of China (81770826); National Key Research and Development Program of China (2017YFA0105803)

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