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Background <p>To explore the differences in routine biochemical indicators and a series of derived inflammatory indicators between Type 1 (T1DM) and Type 2 diabetes mellitus (T2DM) patients with proliferative diabetic retinopathy (PDR) as well as between T1DM patients with PDR and non-proliferative diabetic retinopathy (NPDR), to reveal the metabolic and inflammatory characteristics related to different stages of T1DM and to find potential risk predictors.</p> Methods <p>This research retrospectively collected the data from diabetic patients who visited Hebei Eye Hospital from January 2020 to January 2025. According to the type of diabetes and the stage of retinopathy, the patients were assigned to the T2DM–PDR, T1DM–PDR, and T1DM–NPDR groups. This study gained and compared demographic data, routine blood test (RBT), blood lipid, blood glucose, and liver and kidney function indicators. In addition, multiple derived inflammatory indicators, including neutrophil/lymphocyte ratio (NLR) and monocyte/high-density lipoprotein cholesterol (HDL-C) ratio (MHR), were calculated. Differentially expressed indicators were submitted to univariate logistic regression analysis, and then the significant indicators were incorporated into a multivariate logistic regression model to identify independent influencing factors for PDR onset. Simultaneously, receiver operating characteristic (ROC) curves were plotted to evaluate the predictive performance of the significant indicators for T1DM–PDR.</p> Results <p>A sum of 130 patients was included. Inter-group comparisons revealed that the T1DM–PDR group had considerably higher levels of HDL-C but noticeably lower levels of neutrophils/HDL-C (NHR), MHR, lymphocytes/HDL-C (LHR), platelets/HDL-C (PHR), and TG/HDL-C ratios than the T2DM–PDR group (all <i>p</i> &lt; 0.05). Patients with T1DM–PDR exhibited significantly higher levels of HDL-C, total bilirubin (TBIL), and direct bilirubin (DBIL) but a lower platelet/HDL-C ratio (PHR) than T1DM–NPDR patients (all <i>p</i> &lt; 0.05). Multivariate logistic regression analysis suggested DBIL as an independent protective marker for PDR in T1DM patients (OR = 0.068). ROC curve analysis exhibited good predictive value of DBIL for T1DM–PDR, with an area under the curve (AUC) of 0.799.</p> Conclusions <p>Compared with T2DM–PDR, T1DM–PDR manifests a metabolic inflammatory pattern of high HDL-C and a low lipoprotein-relevant inflammatory ratio. At the same time, in the context of T1DM, the reductions in PHR and the TG/HDL-C ratio may be linked to the occurrence and development of PDR. The ratio related to HDL-C may be a valuable biomarker for distinguishing T1DM–PDR and T2DM–PDR as well as evaluating the progression of PDR in T1DM. DBIL may be a critical biomarker to assess the risk of PDR in T1DM patients.</p>

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Metabolic inflammatory characteristics of type 1 diabetes mellitus-associated proliferative retinopathy and their changes during disease progression: a retrospective study based on derived indicators

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  • 发表日期：

    2026年4月9日

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  • Xiaolu Cao,
  • Yifan Wang,
  • Peipei Jia,
  • Kepeng Zhao,
  • Yi Gao,
  • Hanying Wang,
  • Lingyu Liang,
  • Lifei wang

摘要

Background

To explore the differences in routine biochemical indicators and a series of derived inflammatory indicators between Type 1 (T1DM) and Type 2 diabetes mellitus (T2DM) patients with proliferative diabetic retinopathy (PDR) as well as between T1DM patients with PDR and non-proliferative diabetic retinopathy (NPDR), to reveal the metabolic and inflammatory characteristics related to different stages of T1DM and to find potential risk predictors.

Methods

This research retrospectively collected the data from diabetic patients who visited Hebei Eye Hospital from January 2020 to January 2025. According to the type of diabetes and the stage of retinopathy, the patients were assigned to the T2DM–PDR, T1DM–PDR, and T1DM–NPDR groups. This study gained and compared demographic data, routine blood test (RBT), blood lipid, blood glucose, and liver and kidney function indicators. In addition, multiple derived inflammatory indicators, including neutrophil/lymphocyte ratio (NLR) and monocyte/high-density lipoprotein cholesterol (HDL-C) ratio (MHR), were calculated. Differentially expressed indicators were submitted to univariate logistic regression analysis, and then the significant indicators were incorporated into a multivariate logistic regression model to identify independent influencing factors for PDR onset. Simultaneously, receiver operating characteristic (ROC) curves were plotted to evaluate the predictive performance of the significant indicators for T1DM–PDR.

Results

A sum of 130 patients was included. Inter-group comparisons revealed that the T1DM–PDR group had considerably higher levels of HDL-C but noticeably lower levels of neutrophils/HDL-C (NHR), MHR, lymphocytes/HDL-C (LHR), platelets/HDL-C (PHR), and TG/HDL-C ratios than the T2DM–PDR group (all p < 0.05). Patients with T1DM–PDR exhibited significantly higher levels of HDL-C, total bilirubin (TBIL), and direct bilirubin (DBIL) but a lower platelet/HDL-C ratio (PHR) than T1DM–NPDR patients (all p < 0.05). Multivariate logistic regression analysis suggested DBIL as an independent protective marker for PDR in T1DM patients (OR = 0.068). ROC curve analysis exhibited good predictive value of DBIL for T1DM–PDR, with an area under the curve (AUC) of 0.799.

Conclusions

Compared with T2DM–PDR, T1DM–PDR manifests a metabolic inflammatory pattern of high HDL-C and a low lipoprotein-relevant inflammatory ratio. At the same time, in the context of T1DM, the reductions in PHR and the TG/HDL-C ratio may be linked to the occurrence and development of PDR. The ratio related to HDL-C may be a valuable biomarker for distinguishing T1DM–PDR and T2DM–PDR as well as evaluating the progression of PDR in T1DM. DBIL may be a critical biomarker to assess the risk of PDR in T1DM patients.