RDW/Albumin ratio (RAR) in premature retinopathy: Evaluation of disease risk and progression

Abstract

Purpose: To determine the role of the RDW-Albumin ratio (RAR), an integrative biomarker of the multidimensional dysfunctional state associated with inflammation, oxidative stress and nutrition in retinopathy of prematurity (ROP), in assessment of the risk of disease development and progression. Methods: The medical records of 105 preterm infants were retrospectively analysed. All demographic, clinical and laboratory data were recorded. The population was divided into three subgroups as ROP-tx (treated), ROP-reg (regressed) and no-ROP. RDW and albumin measurements were recorded for all groups at specific time points: day 1 after birth (M1), postnatal 1 month (M2), and postnatal 2 months or before treatment (M3). RDW/Albumin ratios were calculated and risk analyses were performed between subgroups. Results: In all measurements at the specified times, mean RDW values were highest in the ROP-Tx group and lowest in the NO-ROP group, with a gradual decreasing trend. In contrast, albumin levels were lowest in the ROP-Tx group and showed a gradual increase in the other groups. When the mean RAR values were analysed in all measurements, the highest values were observed in the ROP-Tx group. (Mean RAR values of the ROP-Tx group: M1-RAR: 6.99, M2-RAR: 7.25, M3-RAR: 5.71. In the ROP-reg group: M1-RAR: 6.22, M2-RAR: 5.83, M3-RAR: 5.20. The lowest values were observed in the No-ROP group: M1-RAR: 5.62, M2-RAR: 5.48, M3-RAR: 4.86 ). When the groups were evaluated independently, the time course of the mean RAR values was analysed. In the ROP-Tx group, a peak was observed at postnatal month 1, followed by a decline. In the ROP-reg and No-ROP groups, a gradually decreasing RAR curve was observed. All these results were statistically significant (p<0.05) Conclusion: High levels of RAR have been shown to be significantly associated with the risk of development and progression of ROP in preterm infants. RAR has been proposed as an important biomarker in retinopathy of prematurity, reflecting a complex situation related to inflammation, oxidative stress and nutrition.