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The diagnostic value of platelet-to-neutrophil ratio in diabetic macular edema
Huixin Sun1, Yao Li1, Shihan Liu1
1Department of Ophthalmology, The Second Affliated Hospital of Chongqing Medical University, Chongqing, China.
Purpose:
To evaluate the diagnostic value of platelet-to-neutrophil ratio (PNR) in the occurrence of diabetic macular edema (DME) in patients with diabetic retinopathy (DR).
Methods:
This cross-sectional study included 366 participants categorized into four groups: DME group (n = 96), DR group (n = 90, DR without DME), diabetes mellitus (DM) group (n = 90, without DR), and healthy control group (n = 90). PNR was calculated by dividing the platelet count by the neutrophil count. Each subject was classified as one of three DME types according to the optical coherence tomography (OCT) features: diffuse retinal thickening (DRT), cystoid macular edema (CME), serous retinal detachment (SRD). The correlations between the PNR and the occurrence of DME, as well as the DME subtypes based on OCT were investigated. Multivariate logistic regression analysis was employed to determine the risk factors for DME. Receiver operating characteristic (ROC) curve analysis was conducted to assess the predictive value of PNR for DME.
Results:
DME group exhibited significantly lower PNR level compared to the other three groups [50.73 (38.92, 65.20) in DME group, 95.63 (68.83, 120.19) in DR group, 92.39 (72.38, 130.61) in DM group, and 100.66 (75.26, 152.77) in healthy control group, respectively, p < 0.001], but did not differ across the DME subtypes based on OCT (p = 0.548). The ROC curve demonstrated that the PNR could better predict DME (area under the curve = 0.832, 95% confidence interval: 0.773 - 0.891, p < 0.001). When the cut-off value of the PNR was 68.51, the sensitivity was 80.2%, and the specificity was 75.6%. Multivariate regression analysis indicated that PNR ≤ 68.51 was an independent risk factor for DME occurrence in DR patients (Odds ratio = 12.05, 95% confidence interval: 5.93 - 24.47, p < 0.001).
Conclusion:
PNR ≤ 68.51 was strongly associated with the development of DME in DR patients, while no significant differences in PNR levels were observed across the different OCT morphological groups. Hence, PNR may serve as a valuable diagnostic biomarker for identifying DME, thereby enhancing risk stratification and management strategies for patients with DR.
Insights
The platelet-to-neutrophil ratio (PNR) is a potential biomarker for diabetic macular edema (DME) in patients with diabetic retinopathy (DR). A PNR of 68.51 or lower indicates a higher risk of developing DME.
Area of Science:
- Ophthalmology
- Diabetology
- Hematology
Background:
- Diabetic retinopathy (DR) is a leading cause of vision loss.
- Diabetic macular edema (DME) is a major complication of DR, often leading to severe visual impairment.
- Early diagnosis and risk stratification are crucial for managing DR and preventing DME.
Purpose of the Study:
- To investigate the diagnostic value of the platelet-to-neutrophil ratio (PNR) in predicting the occurrence of diabetic macular edema (DME) among patients with diabetic retinopathy (DR).
- To assess the correlation between PNR levels and the presence of DME, including its subtypes.
- To evaluate PNR as a potential biomarker for DME risk stratification in DR patients.
Main Methods:
- A cross-sectional study involving 366 participants, including patients with DME, DR without DME, diabetes mellitus (DM) without DR, and healthy controls.
- Platelet-to-neutrophil ratio (PNR) was calculated by dividing platelet count by neutrophil count.
- Optical coherence tomography (OCT) was used to classify DME subtypes. Multivariate logistic regression and ROC curve analysis were employed to determine risk factors and predictive value.
Main Results:
- The DME group exhibited significantly lower PNR levels compared to other groups (p < 0.001).
- PNR levels did not differ significantly across DME subtypes (p = 0.548).
- ROC curve analysis showed PNR as a good predictor of DME (AUC = 0.832). A PNR cutoff of 68.51 yielded 80.2% sensitivity and 75.6% specificity. PNR ≤ 68.51 was an independent risk factor for DME (OR = 12.05, p < 0.001).
Conclusions:
- A low platelet-to-neutrophil ratio (PNR ≤ 68.51) is strongly associated with the development of DME in patients with DR.
- PNR may serve as a valuable diagnostic biomarker for identifying DME in DR patients.
- PNR can aid in risk stratification and inform management strategies for DR patients at risk of DME.
