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Meta-Analysis
. 2018 Jun 27;38(3):BSR20180172.
doi: 10.1042/BSR20180172. Print 2018 Jun 29.

The association of neutrophil to lymphocyte ratio, mean platelet volume, and platelet distribution width with diabetic retinopathy and nephropathy: a meta-analysis

Juxiang Liu  1   2 , Xingguang Liu  3 , Youpeng Li  4 , Jinxing Quan  2   5 , Suhong Wei  2   5 , Siqin An  2   5 , Ruifei Yang  2 , Jing Liu  6   5
Affiliations
Meta-Analysis

The association of neutrophil to lymphocyte ratio, mean platelet volume, and platelet distribution width with diabetic retinopathy and nephropathy: a meta-analysis

Juxiang Liu et al. Biosci Rep. .

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.

Keywords: Neutrophil to lymphocyte ratio; diabetic nephropathy; diabetic retinopathy; mean platelet volume; platelet distribution width.

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Conflict of interest statement

The authors declare that there are no competing interests associated with the manuscript.

Figures

Figure 1
Figure 1. Flow chart of study selection process
Figure 2
Figure 2. Results of forest plot of the relationship between NLR and DN
Forest plot of the relationship between NLR and DN (A); forest plot of the relationship between NLR and the degree of DN (B).
Figure 3
Figure 3. Results of forest plot of the relationship between NLR and DR
Forest plot of the relationship between NLR and DR (A); forest plot of the relationship between NLR and the degree of DR (B).
Figure 4
Figure 4. Forest plot of the relationship between MPV and DN
Figure 5
Figure 5. Results of forest plot of the relationship between MPV and DR
Forest plot of the relationship between MPV and DR (A); forest plot of the relationship between MPV and the degree of DR (B).
Figure 6
Figure 6. Forest plot of the relationship between PDW and DN
Figure 7
Figure 7. Results of forest plot of the relationship between PDW and DR
Forest plot of the relationship between PDW and DR (A); forest plot of the relationship between PDW and the degree of DR (B).
Figure 8
Figure 8. The sensitive analysis of selected studies
NLR for DN (A), NLR for DR (B), MPV for DN (C), MPV for DR (D), PDW for DR (E).
Figure 9
Figure 9. The funnel plots for the assessment of potential publication bias
NLR for DN (A), NLR for DR (B), MPV for DR (C), MPV for DR (D), PDW for DR (E).
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