The Ratio of Fibrinogen to Albumin is Related to the Occurrence of Retinopathy in Type 2 Diabetic Patients

Overview

Journal Diabetes Metab Syndr Obes

Publisher Dove Medical Press

Specialty Endocrinology

Date 2023 Jun 29

PMID 37384130

Authors

Xiaoyi Chen

Jingyu Zhao

Yanxue You

Zelin Li

Shuchun Chen

Affiliations

Soon will be listed here.

Abstract

Purpose: Type 2 diabetic retinopathy is a long-term chronic inflammatory disease. The aim of this study was to investigate the relationship between fibrinogen to albumin ratio (FAR) and retinopathy in type 2 diabetic patients.

Methods: This was a retrospective study that included 500 patients with type 2 diabetes mellitus (T2DM), and were divided into non-diabetic retinopathy group (NDR, n=297) and diabetic retinopathy group (DR, n=203) according to fundus examination findings, and the DR group was further divided into non-proliferative retinopathy group (NPDR, n=182) and proliferative retinopathy group (PDR, n=21). Baseline data of patients were collected, and the fibrinogen to albumin ratio (FAR) and neutrophil to lymphocyte ratio (NLR) were calculated to analyze the correlation between FAR and NLR and type 2 diabetic retinopathy.

Results: The FAR and NLR were significantly higher in the DR group compared with the NDR group (both < 0.001). Spearman correlation analysis showed that FAR was positively correlated with NLR and DR ( < 0.05). As the FAR quartile increased, the prevalence of DR increased (14.8%, 16.7%, 25.1%, and 43.30%, respectively; < 0.05). Multifactorial logistic regression analysis showed that FAR, diabetic course, systolic blood pressure (SBP) and diabetic peripheral neuropathy (DPN) were risk factors for the development of DR in patients with T2DM. The area under the ROC curve for FAR to predict DR progression was 0.708, with an optimal critical value of 7.04, and the area under the ROC curve for diabetes duration and SBP to predict DR was 0.705 and 0.588, respectively.

Conclusion: Our findings show for the first time that FAR is an independent risk factor for assessing DR in patients with type 2 diabetes.

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References

Huang Q, Wu H, Wo M, Ma J, Song Y, Fei X . Clinical and predictive significance of Plasma Fibrinogen Concentrations combined Monocyte-lymphocyte ratio in patients with Diabetic Retinopathy. Int J Med Sci. 2021; 18(6):1390-1398. PMC: 7893560. DOI: 10.7150/ijms.51533. View

Wilkinson C, Ferris 3rd F, Klein R, Lee P, Agardh C, Davis M . Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 2003; 110(9):1677-82. DOI: 10.1016/S0161-6420(03)00475-5. View

Esmon C . Crosstalk between inflammation and thrombosis. Maturitas. 2009; 61(1-2):122-31. DOI: 10.1016/j.maturitas.2008.11.008. View

Sinclair S, Schwartz S . Diabetic Retinopathy-An Underdiagnosed and Undertreated Inflammatory, Neuro-Vascular Complication of Diabetes. Front Endocrinol (Lausanne). 2020; 10:843. PMC: 6923675. DOI: 10.3389/fendo.2019.00843. View

Villegas V, Schwartz S . Current and Future Pharmacologic Therapies for Diabetic Retinopathy. Curr Pharm Des. 2019; 24(41):4903-4910. DOI: 10.2174/1381612825666190130140717. View

Luyendyk J, Schoenecker J, Flick M . The multifaceted role of fibrinogen in tissue injury and inflammation. Blood. 2018; 133(6):511-520. PMC: 6367649. DOI: 10.1182/blood-2018-07-818211. View

Demir O, Demirag G, Aslan G . Prospective evaluation of hematological parameters in preoperative renal cell cancer patients. BMC Urol. 2022; 22(1):201. PMC: 9741773. DOI: 10.1186/s12894-022-01118-0. View

Sui J, Noubouossie D, Gandotra S, Cao L . Elevated Plasma Fibrinogen Is Associated With Excessive Inflammation and Disease Severity in COVID-19 Patients. Front Cell Infect Microbiol. 2021; 11:734005. PMC: 8369350. DOI: 10.3389/fcimb.2021.734005. View

Cheung N, Mitchell P, Wong T . Diabetic retinopathy. Lancet. 2010; 376(9735):124-36. DOI: 10.1016/S0140-6736(09)62124-3. View

10.

Wang J, Chen Z, Yang K, Yang H, Tao W, Li Y . Association between neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and diabetic retinopathy among diabetic patients without a related family history. Diabetol Metab Syndr. 2020; 12:55. PMC: 7331251. DOI: 10.1186/s13098-020-00562-y. View

11.

Smiley S, King J, Hancock W . Fibrinogen stimulates macrophage chemokine secretion through toll-like receptor 4. J Immunol. 2001; 167(5):2887-94. DOI: 10.4049/jimmunol.167.5.2887. View

12.

Puavilai G, Chanprasertyotin S, Sriphrapradaeng A . Diagnostic criteria for diabetes mellitus and other categories of glucose intolerance: 1997 criteria by the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (ADA), 1998 WHO consultation criteria, and 1985 WHO criteria. World.... Diabetes Res Clin Pract. 1999; 44(1):21-6. DOI: 10.1016/s0168-8227(99)00008-x. View

13.

Alharbi A, Alhazmi A . Prevalence, Risk Factors, and Patient Awareness of Diabetic Retinopathy in Saudi Arabia: A Review of the Literature. Cureus. 2021; 12(12):e11991. PMC: 7793362. DOI: 10.7759/cureus.11991. View

14.

Wang W, Lo A . Diabetic Retinopathy: Pathophysiology and Treatments. Int J Mol Sci. 2018; 19(6). PMC: 6032159. DOI: 10.3390/ijms19061816. View

15.

Esmon C . Inflammation and thrombosis. J Thromb Haemost. 2003; 1(7):1343-8. DOI: 10.1046/j.1538-7836.2003.00261.x. View

16.

Oshitari T . Neurovascular Impairment and Therapeutic Strategies in Diabetic Retinopathy. Int J Environ Res Public Health. 2022; 19(1). PMC: 8744686. DOI: 10.3390/ijerph19010439. View

17.

Zhu Y, Cai X, Liu Y, Hu M, Zhou L, Liu W . Serum Albumin, but not Bilirubin, is Associated with Diabetic Chronic Vascular Complications in a Chinese Type 2 Diabetic Population. Sci Rep. 2019; 9(1):12086. PMC: 6700065. DOI: 10.1038/s41598-019-48486-6. View

18.

Mosesson M . Fibrinogen and fibrin structure and functions. J Thromb Haemost. 2005; 3(8):1894-904. DOI: 10.1111/j.1538-7836.2005.01365.x. View

19.

Vincent J, Russell J, Jacob M, Martin G, Guidet B, Wernerman J . Albumin administration in the acutely ill: what is new and where next?. Crit Care. 2014; 18(4):231. PMC: 4223404. DOI: 10.1186/cc13991. View

20.

Torun A, Damar Cakirca T, Cakirca G, Portakal R . The value of C-reactive protein/albumin, fibrinogen/albumin, and neutrophil/lymphocyte ratios in predicting the severity of CoVID-19. Rev Assoc Med Bras (1992). 2021; 67(3):431-436. DOI: 10.1590/1806-9282.20200883. View