Abstract:

Objective To explore the clinical significance of neutrophil to lymphocyte ratio (NLR) in diagnosis and monitoring of diabetic retinopathy (DR). Design Meta-analysis. Participants Published clinical studies reporting both NLR and DR. Methods Literatures were retrieved by formal searching of PubMed, Embase, Cochrane, CNKI and WanFang, and by hand searching of reference lists of related articles. Review manager 5.3 and Stata 14.0 statistical softwares were utilized for processing, and effect model was changed to perform sensitivity analysis, and publication bias was conducted by Egger’s test. Main Outcome Measures NLR level. Results  Eleven eligible studies involving 982 DR patients, 1224 type Ⅱdiabetes mellitus (T2DM) without DR patients and 683 healthy subjects were included. Meta-analysis showed that NLR level in DR was significantly higher than healthy controls [SMD (95% CI) =0.90 (0.36, 1.44), P<0.001] and T2DM without DR [SMD (95% CI) =0.69 (0.41, 0.97), P<0.001], respectively. Subgroups suggested that there was no statistical significance of NLR between nonproliferative diabetic retinopathy and proliferative diabetic retinopathy. Conclusion The higher level NLR appeares in DR compared to control and T2DM without DR, which suggests the risk of retinopathy in T2DM and might provides an evidence to monitor the development of DR clinically.

Key words: neutrophil to lymphocyte ratio, diabetic retinopathy, Meta-analysis