ArticleAmerican journal of translational research2025
A hematologic composite score integrating iron, coagulation, and inflammation markers predicts diabetic retinopathy severity: a retrospective cross-sectional study.
Article in American journal of translational research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThis study aimed to develop and validate a hematological composite score incorporating ferritin, transferrin, fibrinogen, and the neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte ratios (PLR) to predict diabetic retinopathy (DR) severity.
methodsIn this single-center retrospective cross-sectional study, 356 patients with type 2 diabetes were categorized into non-DR (n=142), non-proliferative DR (NPDR, n=112), and proliferative DR (PDR, n=102). The composite score was calculated as: (Ferritin × Fibrinogen × NLR × PLR)/Transferrin. Multivariable logistic regression and receiver operating characteristic (ROC) analyses were conducted to evaluate predictive performance, adjusting for relevant covariates.
resultsThe composite score showed strong discriminatory ability for identifying PDR (AUC=0.898; 95% CI: 0.85-0.93), significantly outperforming individual markers (e.g., ferritin AUC=0.744, fibrinogen AUC=0.722; P<0.001). Each standard deviation increase in the score was associated with a 2.8-fold higher odds of PDR (adjusted OR=2.83; 95% CI: 2.12-3.78). Subgroup analysis revealed greater predictive accuracy in patients with diabetes duration ≥10 years (AUC=0.92) compared to those with <10 years (AUC=0.82; P for interaction =0.012).
conclusionsThis hematologic composite score, integrating iron, coagulation, and inflammation markers, offers a cost-effective and clinically accessible tool for DR severity assessment, particularly in patients with long-standing diabetes. Its implementation may enhance screening precision and inform individualized management strategies.
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