title: Neutrophil-to-lymphocyte ratio as a quick and reliable predictive marker to diagnose the severity of diabetic retinopathy.
abstract: BACKGROUND
  Diabetic retinopathy (DR) is the most common complication and cause of visual impairment in diabetes patients. The pathogenesis is not fully understood, but several studies have suggested that inflammation plays an important role. The neutrophil-to-lymphocyte ratio (NLR) was defined as a novel potential marker to determine inflammation. We aimed to evaluate the relationship between DR and inflammation by using NLR.
  
  
  METHODS
  The study was included 58 patients diagnosed with type 2 diabetes mellitus. Twenty-four of them had DR. The control group was composed of 52 age- and sex-matched healthy subjects. Retinopathy was graded using the International Clinical Diabetic Retinopathy Disease Severity Scale.
  
  
  RESULTS
  NLR values of the diabetes patients were significantly higher than those of the healthy control group (P<0.001), and NLR levels of the patients with DR were higher than those of the patients without DR (P<0.001). In addition, NLR values were correlated with the presence of DR and DR grades (r=0.466, P<0.001; and r=0.630, P<0.001, respectively).
  
  
  CONCLUSIONS
  According to our knowledge, this is the first study investigating the relationship between NLR, which is an inflammatory marker, and DR and its severity. Our results suggest that while evaluating diabetes patients in terms of DR, higher NLR values may be a remarkable marker.
authors.affiliation: 1 Department of Internal Medicine and Nephrology, Afyon Kocatepe University , Faculty of Medicine, Afyonkarahisar, Turkey .
authors.forename: Sena Memnune
authors.initials: SM
authors.lastname: Ulu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Dogan
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ahsen
authors.forename: Abdullah
authors.initials: A
authors.lastname: Altug
authors.forename: Kasım
authors.initials: K
authors.lastname: Demir
authors.forename: Gürsel
authors.initials: G
authors.lastname: Acartürk
authors.forename: Sibel
authors.initials: S
authors.lastname: Inan
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000276:immunology* / Q000378:metabolism; D003930:Diabetic Retinopathy / Q000453:epidemiology / Q000276:immunology* / Q000378:metabolism; D005260:Female; D006801:Humans; D007249:Inflammation / Q000453:epidemiology / Q000276:immunology*; D007958:Leukocyte Count; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000378:metabolism*; D008297:Male; D009504:Neutrophils / Q000378:metabolism*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D014421:Turkey / Q000453:epidemiology
chemical_list: D015415:Biomarkers