Akademik Veri Yönetim Sistemi
Genel Tip Dergisi, cilt.35, sa.5, ss.825-837, 2025 (Scopus, TRDizin)
Aim: Diabetic retinopathy is a common microvascular complication of diabetes mellitus, and proliferative diabetic retinopathy(PDR)represents its most advanced form, often leading to vision loss. Early identification of high-risk patients through accessible biomarkers may enable more effective monitoring and timely intervention. This study aimed to evaluate the association between systemic hematologic and biochemical biomarkers and retinopathy severity. Methods: This retrospective study included 111 patients with diabetes mellitus, categorized into three groups based on fundoscopic ñndings: Non-retinopathic diabetes mellitus, non-proliferative diabetic retinopathy(NPDR), and PDR. Hematologic biomarkers including neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index(SII), systemic inflammatory response index(SIRI), monocyte-to-lymphocyte ratio(MLR), and eosinophil-to-monocyte ratio were evaluated along with biochemical markers such as urea, creatinine, albumin, and bilirubin. Receiver operating characteristic(ROC)curves and logistic regression were used to assess predictive ability for PDR. Results: Neutrophil count, NLR, PLR, SII, SIRI, and MLR significantly increased with advancing retinopathy, while lymphocyte count, hemoglobin, hematocrit, and albumin decreased. ROC analysis showed that NLR (AUC: 0.782), PLR(AUC: 0.758), SII(AUC: 0.760), SIRI(AUC: 0.771), MLR(AUC: 0.748), and neutrophil count (AUC: 0.743) were effective in distinguishing PDR. Logistic regression identiñed SIRI (OR: 3.475), NLR (OR: 3.369), MLR (OR: 1.971), PLR (OR: 1.024), SII (OR: 1.005), and neutrophil count (OR: 1.838)as independent predictors. These markers followed consistent trends across diabetic retinopathy stages and showed signiñcant correlation with proliferative changes. Among them, SIRI and NLR showed the strongest association with PDR, exceeding traditional biochemical parameters in predictive performance. Conclusions: Systemic infammatory biomarkers—particularly SIRI, NLR, PLR, MLR, and SII—are independently associated with PDR. These widely available and cost-effective markers may aid in early risk stratiñcation and help guide ophthalmologic referrals in clinical practice.