Albumin-to-neutrophil-lymphocyte ratio: a novel dual-pathway biomarker for diabetic retinopathy risk assessment

作者：Chongyang She, Yong Tao, Shuo Yang · 发表于：Frontiers in Endocrinology · 年份：2025 · DOI：10.3389/fendo.2025.1687507 · 被引用次数：3 · 研究领域：Retinal Diseases and Treatments、Inflammatory Biomarkers in Disease Prognosis、Retinal Imaging and Analysis

Background Diabetic retinopathy (DR) represents a leading cause of blindness globally, with conventional risk factors inadequately explaining disease occurrence and progression. The albumin-to-neutrophil-lymphocyte ratio (ANLR), a composite biomarker integrating nutritional and inflammatory status, has shown predictive value in various diabetic complications but its relationship with DR remains unexplored. Methods This cross-sectional study utilized National Health and Nutrition Examination Survey (NHANES) data from 1998–2020 cycles to investigate the association between ANLR and DR in diabetic patients with external validation in an independent study. ANLR was calculated as serum albumin divided by neutrophil-to-lymphocyte ratio. DR status was assessed through self-reporting in NHANES and ophthalmologic examination in the validation study. Survey-weighted generalized linear models were employed to evaluate associations, with participants stratified into quartiles based on ANLR values. Restricted cubic spline analysis examined nonlinear relationships, and subgroup analyses explored effect modification. Results A total of 6,279 diabetic participants were included in the NHANES analysis and 212 in the external validation study. After multivariable adjustment, higher ANLR quartiles demonstrated significantly reduced DR risk compared to Q1: Q2 (OR = 0.59, 95%CI: 0.38-0.91, P = 0.018), Q3 (OR = 0.73, 95%CI: 0.47-1.13, P = 0.164, non-significant), and Q4 (OR = 0.57, 95%CI: 0.36-0.9...