title: Neutrophil-Lymphocyte ratio is associated with arterial stiffness in diabetic retinopathy in type 2 diabetes.
abstract: OBJECTIVE
  Diabetic retinopathy (DR) is the most common complication of type 2 diabetes mellitus (T2DM). Inflammation plays a considerable role in the pathogenesis of T2DM and DR. Emerging evidence revealed that the neutrophil-lymphocyte ratio (NLR) may be a useful marker of cardiovascular disease. The brachial-ankle pulse wave velocity (baPWV) is an indicator for early atherosclerotic changes. Therefore, this study aimed to investigate the association of NLR with baPWV in patients with DR.
  
  
  METHODS
  In this cross-sectional study, we investigated the relationship between NLR and baPWV in 402 participants. Participants were divided into the following three groups: 133 control subjects without T2DM; 138 diabetic subjects without DR; and 131 patients with DR.
  
  
  RESULTS
  NLR and baPWV were elevated both in T2DM and in DR. Moreover, compared to T2DM, NLR and baPWV were higher in DR. There was a positive correlation between NLR and baPWV in patients with T2DM and DR after adjusting confounding factors. Multiple linear regression analysis further revealed that NLR was an independent and significant determinant for elevated baPWV (for T2DM, β=0.170; p=0.041; for DR, β=0.188; p=0.022, respectively).
  
  
  CONCLUSIONS
  The findings showed that NLR and baPWV are elevated both in T2DM and in DR. In addition, NLR is independently associated with baPWV. Early detection of abnormal NLR levels may be helpful for the search of subclinical atherosclerosis in patients with T2DM and DR.
authors.affiliation: Department of Geriatrics, the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China.
authors.forename: Rui-tao
authors.initials: RT
authors.lastname: Wang
authors.affiliation: Department of Geriatrics, the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China.
authors.forename: Ji-rong
authors.initials: JR
authors.lastname: Zhang
authors.affiliation: Department of Geriatrics, the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China; International Physical Examination and Healthy Center, the Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.affiliation: Division of Hypothalamic Research, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, 75390, USA.
authors.forename: Tiemin
authors.initials: T
authors.lastname: Liu
authors.affiliation: Department of Intensive Care Unit, the Third Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China. Electronic address: kaijiang_yu@yeah.net.
authors.forename: Kai-jiang
authors.initials: KJ
authors.lastname: Yu
mesh_terms: D000368:Aged; D000465:Algorithms; D055109:Ankle Brachial Index; D001158:Arteries / Q000276:immunology / Q000503:physiopathology; D058070:Asymptomatic Diseases; D050197:Atherosclerosis / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000276:immunology / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000175:diagnosis* / Q000453:epidemiology; D003930:Diabetic Retinopathy / Q000097:blood / Q000276:immunology* / Q000503:physiopathology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology*; D063177:Pulse Wave Analysis; D012307:Risk Factors; D059289:Vascular Stiffness
chemical_list: D015415:Biomarkers
keywords: Arterial stiffness; Brachial-ankle pulse wave velocity; Diabetic retinopathy; Neutrophil–Lymphocyte ratio; Type 2 diabetes mellitus