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Int. J. Environ. Res. Public Health 2015, 12(8), 10009-10019; doi:10.3390/ijerph120810009

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

Department of Ophthalmology, The First Affiliated Hospital of China Medical University, No.155 Nanjing North Street, Heping District, Shenyang 110001, China
Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
These authors contributed equally to this work.
Authors to whom correspondence should be addressed.
Academic Editor: Omorogieva Ojo
Received: 9 July 2015 / Revised: 13 August 2015 / Accepted: 18 August 2015 / Published: 21 August 2015
(This article belongs to the Collection Health Care and Diabetes)
View Full-Text   |   Download PDF [244 KB, uploaded 21 August 2015]   |  


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. View Full-Text
Keywords: platelet-to-lymphocyte ratio; monocyte-to-lymphocyte ratio; neutrophil-to-lymphocyte ratio; diabetic retinopathy platelet-to-lymphocyte ratio; monocyte-to-lymphocyte ratio; neutrophil-to-lymphocyte ratio; diabetic retinopathy

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MDPI and ACS Style

Yue, S.; Zhang, J.; Wu, J.; Teng, W.; Liu, L.; Chen, L. Use of the Monocyte-to-Lymphocyte Ratio to Predict Diabetic Retinopathy. Int. J. Environ. Res. Public Health 2015, 12, 10009-10019.

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