Abstract

The aim of the present study was to investigate the correlation of neutrophil to lymphocyte ratio (NLR), mean platelet volume (MPV), and platelet distribution width (PDW) with diabetic nephropathy (DN) and diabetic retinopathy (DR). We searched for eligible studies from PubMed, Embase, Web of Science, and CNKI up to 1 December 2017. Standardized mean difference (SMD) was calculated with a confidence interval (CI) of 95%. A total of 48 studies were included in our meta-analysis. Compared with patients with type Ⅱ diabetes mellitus (T2DM) and without DR, NLR, MPV, and PDW were higher in patients with DR (SMD = 0.77; 95% CI: 0.49–1.05; P<0.001; SMD = 0.68; 95% CI: 0.36–0.99; P<0.001; SMD = 0.52; 95% CI: 0.28–0.76; P<0.01). Compared with patients with T2DM and without DN, NLR, MPV, and PDW were higher in patients with DN (SMD = 0.63; 95% CI: 0.43–0.83; P<0.001; SMD = 0.81; 95% CI: 0.36–1.25; P<0.001; SMD = 0.70; 95% CI: 0.50–0.90; P<0.001). We also found that MPV was strongly associated with the severity of DR, and NLR was closely related to the degree of DN. Our findings indicated that NLR, MPV, and PDW could be recommended as inexpensive diagnostic biomarkers for DN and DR. However, considering several limitations in the present study, further high-quality clinical studies should be performed to investigate the relationship of NLR, MPV, and PDW to DN and DR.

Highlights

  • Diabetes is a global health burden and its morbidity and mortality are increasing in recent decades, especially in populations from the low- and middle-income countries [1,2]

  • We found that mean platelet volume (MPV) was strongly associated with the severity of diabetic retinopathy (DR), and neutrophil to lymphocyte ratio (NLR) was closely related to the degree of diabetic nephropathy (DN)

  • The publication bias test was not applicable for the pooled Standardized mean difference (SMD) of platelet distribution width (PDW) for DN owing to the limitation of the number of the eligible studies. This is the first meta-analysis focussing on the association of NLR, MPV, and PDW with DN and DR

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Summary

Introduction

Diabetes is a global health burden and its morbidity and mortality are increasing in recent decades, especially in populations from the low- and middle-income countries [1,2]. DR and DN are serious microvascular complications and have been considered as the major cause of blindness and end-stage renal failure, respectively [3,4,5]. It is very significant for clinicians and researchers to elucidate pathogenesis of DR and DN and identify high-risk patients. Diabetes mellitus (DM) is a chronic systemic disease. Accumulated evidence have implicated that inflammatory response plays a key part in the c 2018 The Author(s).

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