Study on the Association of Monocyte Lymphocyte Ratio in Proliferative Diabetic Retinopathy and Control of Diabetes

Abstract

This cross-sectional study aimed to assess the clinical and predictive significance of the monocyte-to-lymphocyte ratio (MLR) in type 2 diabetes mellitus patients with proliferative diabetic retinopathy (PDR). The study was conducted on 100 diabetic retinopathy patients admitted to the General Medicine Department at Kempegowda Institute of Medical Sciences over an 18-month period. Fundoscopy was used to diagnose and classify diabetic retinopathy into non-proliferative (NPDR) and proliferative (PDR) forms. Blood investigations, including a complete blood count (CBC) and HbA1c, were performed, and statistical analyses were conducted using SPSS (Version 26.0). The results indicated that the mean age of the study participants was 66.89 ± 13.16 years, with 62% being male. Among the study group, 80% had NPDR, and 20% had PDR. The mean duration of diabetes mellitus was 9.90 ± 2.96 years, with a mean HbA1c level of 8.80 ± 1.11, reflecting suboptimal glycemic control. The mean MLR for the entire cohort was 0.176 ± 0.0791, with PDR patients exhibiting a lower MLR (0.162 ± 0.074) compared to NPDR patients (0.179 ± 0.080); however, this difference was not statistically significant (p = 0.373). No significant correlation was found between the MLR and HbA1c levels (r = -0.071; p = 0.484), suggesting that MLR does not have a meaningful relationship with glycemic control in this population. Additionally, ROC curve analysis revealed an AUC of 0.438, with high sensitivity (95%) and specificity (98.8%) but poor overall diagnostic utility for MLR in predicting PDR. The findings indicate that while MLR may have some relevance in diabetic retinopathy, its predictive ability for PDR is limited.