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Analysis of the Correlation Between Prognostic Nutritional Index and Diabetic Retinopathy in Patients with Diabetes
1Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nan Chong 637000, Sichuan Province, China.
Introduction:
This study aimed to investigate the correlation between Prognostic Nutritional Index (PNI) and diabetic retinopathy (DR) in patients with diabetes.
Methods:
In this cross-sectional NHANES study, 3,318 diabetic patients aged ≥40 years were analyzed. PNI was calculated as: serum albumin (g/L) + 5 × lymphocyte count (109/L). Statistical analyses incorporated complex sampling survey design methods. Associations between DR and PNI were assessed using univariate and multivariate logistic regression models, with restricted cubic splines detecting potential non-linearity. Subgroup analyses examined population-specific effects.
Results:
Among the participants, 679 (18%) had DR. Patients with DR exhibited significantly lower PNI (50.46 ± 5.35) than those without DR (52.26 ± 6.07, P < 0.001). After adjusting for covariates- including age, sex, race, education, BMI, smoking status, hypertension, coronary heart disease, anemia, and blood glucose management-PNI remained inversely associated with DR risk (OR = 0.96, 95% CI: 0.94-0.98, P < 0.01). Restricted cubic spline analysis confirmed a non-linear relationship between PNI and DR (P = 0.01). Subgroup analyses showed significant inverse associations in patients aged 40-59 (OR = 0.93, 95% CI: 0.88-0.98, P = 0.01) and 60-79 (OR = 0.93, 95% CI: 0.89-0.96, P < 0.01), in overweight (OR = 0.94, 95% CI: 0.90-0.98, P < 0.01) and obese individuals (OR = 0.93, 95% CI: 0.89-0.96, P < 0.01), and in those using no medication (OR = 0.95, 95% CI: 0.90-0.99, P = 0.02) or oral hypoglycemic agents (OR = 0.96, 95% CI: 0.92-1.00, P = 0.04). The inverse association was not significant in patients with anemia or coronary heart disease (all quartiles P > 0.05).
Discussion:
This study demonstrates a significant non-linear inverse association between PNI and DR risk, particularly among adults aged 40-79 years and overweight/obese individuals, while the relationship was attenuated in those with anemia or coronary heart disease. As a composite nutritional- inflammatory marker, PNI may reflect overall health status in diabetic patients.
Conclusion:
PNI shows potential as a simple biomarker for DR risk stratification. Prospective validation is needed before clinical application.
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