| Objective:Diabetic retinopathy(DR)is one of the most common causes of blindness and visual impairment.The pathogenesis of DR is not fully understood,but studies suggest that chronic inflammation plays an important role.It is now widely accepted that abnormalities in retinal function can be detected in patients without any evidence of microvascular abnormalities.Therefore,finding easy,quick and feasible predictors can help in the early diagnosis and prevention of DR.Fibrinogen to albumin ratio(FAR),an emerging marker of inflammation and oxidative stress,has been shown to correlate with the prognosis of several diseases,but its correlation with DR has not yet been reported in studies.The aim of this study was to investigate the correlation between FAR and type 2 diabetes mellitus and to analyze the value of FAR in predicting DR.Methods:This was a cross-sectional study,a total of 550 patients with a definite diagnosis of type 2 diabetes at the Hebei General Hospital between August2019 and June 2021 were selected.And the study population was enrolled strictly according to the inclusion and exclusion criteria,and 500 study subjects were finally included.The patients were divided into DR group and NDR(Non-diabetic retinopathy,NDR)group according to whether they had combined type 2 diabetic retinopathy,and then further divided into PDR group and NDR(Non-proliferative diabetic retinopathy,NDR)group according to the degree of fundus lesions.The general data,clinical biochemical indexes and coagulation parameters were collected,and the patients’ FAR was calculated based on fibrinogen and albumin levels,and NLR was calculated based on neutrophil and lymphocyte levels.And all patients with FAR were divided into four groups according to quartiles: 125 patients in group A(FAR < 5.369),125 patients in group B(5.369 ≤ FAR <6.192),125 patients in group C(6.192 ≤ FAR < 7.188),and 125 patients in group D(FAR ≥ 7.188),and the differences in the prevalence of DR among patients with different FAR levels were analyzed.SPSS 25.0 was applied for data statistics.The risk factors of retinopathy in type 2 diabetic patients were analyzed,and the role of FAR in type 2 diabetic retinopathy was discussed.Results:1.General data: Compared with the NDR group,patients in the DR group had significantly higher DM duration,age,SBP,DPN,Hb A1 c,FIB,NC,LC,NLR,and FAR,and significantly lower BMI,SUA,ALT,AST and ALB than the NDR group(P < 0.05).The duration of DM,FIB,NLR,and FAR were significantly higher in the PDR group compared with the NPDR group(P < 0.05).2.Correlation between FAR and other indexes: FAR showed positive correlation with age,gender,DM duration,SBP,hypertension,DR,DPN,Hb A1 c,FIB,NC,and NLR(P < 0.05),and negative correlation with smoking status,alcohol intake,SUA,SCr,ALT,AST,and ALB(P < 0.05).3.Logistic regression analysis: FAR,duration of DM,SBP,and DPN were independent risk factors for the development of DR in patients with T2 DM.Among them,each unit increase in FAR was associated with a0.507-fold increase in the likelihood of DR in T2 DM patients,controlling for other independent variables(P < 0.001).4.Trend test for the risk of developing DR at different FAR levels:When corrected for age,duration of diabetes,SBP,BMI,DPN,Hb A1 c,SUA,ALT,AST,FIB,NC,LC and NLR the results showed a progressive increase in the risk of developing DR with increasing FAR levels(P-trend< 0.001).5.ROC curve: According to the results of ROC curve,the area under the ROC curve for FAR,DM duration,and SBP to predict DR progression was 0.708,0.705,and 0.588,respectively.The risk of DR increases when FAR > 7.04.Conclusion:1.FAR levels in type 2 diabetic patients are associated with the development of DR,and the risk of DR prevalence increases with increasing FAR levels.2.FAR,duration of DM,SBP,and DPN are independent risk factors for the development of DR in patients with type 2 diabetes.3.FAR has some predictive value for the development of DR in patients with type 2 diabetes. |
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