The neutrophil percentage‐to‐albumin ratio is related to the occurrence of diabetic retinopathy

Abstract

Background Among patients with diabetic retinopathy (DR), no proof was available to confirm the prognostic significance of the neutrophil percentage‐to‐albumin ratio (NPAR). We hypothesized that NPAR plays a role in the incidence of DR in diabetic patients. Methods We extracted all diabetes mellitus (DM) data from the National Health and Nutrition Examination Survey (NHANES) database between 1999 and 2018, NPAR was expressed as neutrophil percentage/albumin. Multivariable logistic regression and generalized additive model were utilized for the purpose of examining the correction between NPAR levels and DR. Subgroup analysis of the associations between NPAR and DR was carried out to investigate if the impact of the NPAR varied among different subgroups. Results An aggregate of 5850 eligible participants were included in the present research. The relationship between NPAR levels and DR was positive linear. In the multivariate analysis, following the adjustment for confounders (gender, white blood cell, age, monocyte percent, red cell distribution width, eosinophils percent, bicarbonate, body mass index, iron, glucose, basophils percent, total bilirubin, creatinine, and chloride), higher NPAR was an independent risk factor for DR compared to lower NPAR (OR, 95% CI: 1.18, 1.00–1.39; 1.24, 1.04–1.48). For the purpose of sensitivity analysis, we found a trend of consistency (p for trend: 0.0190). The results of the subgroup analysis revealed that NPAR did not exert any statistically significant interactions with any of the other DR risk variables. Conclusions Elevated NPAR is associated with an elevated risk of occurrence of DR in diabetic patients.

Cellular communication network factor 1 promotes retinal leakage in diabetic retinopathy via inducing neutrophil stasis and neutrophil extracellular traps extrusion

“…7B). Additionally, the NLR is a marker of systemic in ammation and has previously been reported to positively correlate with DR [4], as is NAR [53]. We also observed a positive correlation between circulating CCN1 and NLR (Fig.…”

Immunology of chronic low-grade inflammation: relationship with metabolic function

“…Animal studies have demonstrated that inhibition of NETs formation by using a peptidyl arginine deiminase 4 (PAD4) inhibitor to prevent the citrullination of histones and subsequent destabilization of chromatin within neutrophils can ameliorate endothelial dysfunction (Gupta et al 2022) and that inhibition of NLRP3 inflammasome activity reduces DKD severity (Zhang et al 2019a). Similarly, various studies have also implicated neutrophil activity in diabetic retinopathy (He et al 2022), acute lung injury (Jiang et al 2014), peripheral neuropathy (Chen et al 2021), and foot ulcers (Lee et al 2020). Taken together, these studies confirm the role of constitutive neutrophil activity in disease progression under conditions of sterile metabolic inflammation.…”

Predictive model for diabetic retinopathy under limited medical resources: A multicenter diagnostic study

“…eGFR was calculated using equations from the Modification of Diet in Renal Disease (MDRD), according to current recommendations ( 5 ). NLR, PLR, LMR, SII, and NPAR have been used to evaluate systemic inflammation, and these novel markers were recently found to be related to DR based on results from the National Health and Nutrition Examination Survey (NHANES) ( 27 – 29 ).…”