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Abstract：
The aim of this study was to establish whether multiple blood parameters might predict an early treatment response to intravitreal bevacizumab injections in patients with diabetic macular edema (DME). Seventy-eight patients with non-proliferative diabetic retinopathy (NPDR) and DME were included. The treatment response was evaluated with central macular thickness decrease and best corrected visual acuity increase one month after the last bevacizumab injection. Parameters of interest were the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), vitamin D, and apolipoprotein B to A-I ratio (ApoB/ApoA-I). The NLR (2.03 ± 0.70 vs. 2.80 ± 1.08; p < 0.001), MLR (0.23 ± 0.06 vs. 0.28 ± 0.10; p = 0.011), PLR (107.4 ± 37.3 vs. 135.8 ± 58.0; p = 0.013), and SII (445.3 ± 166.3 vs. 675.3 ± 334.0; p < 0.001) were significantly different between responder and non-responder groups. Receiver operator characteristics analysis showed the NLR (AUC 0.778; 95% CI 0.669-0.864), PLR (AUC 0.628; 95% CI 0.511-0.735), MLR (AUC 0.653; 95% CI 0.536-0.757), and SII (AUC 0.709; 95% CI 0.595-0.806) could be predictors of response to bevacizumab in patients with DME and NPDR. Patients with severe NPDR had a significantly higher ApoB/ApoA-I ratio (0.70 (0.57-0.87) vs. 0.61 (0.49-0.72), p = 0.049) and lower vitamin D (52.45 (43.10-70.60) ng/mL vs. 40.05 (25.95-55.30) ng/mL, p = 0.025). Alterations in the NLR, PLR, MLR, and SII seem to provide prognostic information regarding the response to bevacizumab in patients with DME, whilst vitamin D deficiency and the ApoB/ApoA-I ratio could contribute to better staging.
摘要：
这项研究的目的是确定多种血液参数是否可以预测糖尿病性黄斑水肿（DME）患者对玻璃体内贝伐单抗注射的早期治疗反应。包括78例非增殖性糖尿病视网膜病变（NPDR）和DME患者。在最后一次贝伐单抗注射后1个月，中心黄斑厚度减少和最佳矫正视力增加评估治疗反应。感兴趣的参数是中性粒细胞与淋巴细胞比率（NLR），单核细胞与淋巴细胞比率（MLR），血小板与淋巴细胞比率（PLR），全身免疫炎症指数（SII），维生素D,和载脂蛋白B与A-I的比率(ApoB/ApoA-I)。NLR(2.03±0.70vs.2.80±1.08；p<0.001），MLR(0.23±0.06vs.0.28±0.10；p=0.011），PLR(107.4±37.3vs.135.8±58.0；p=0.013），和SII（445.3±166.3vs.675.3±334.0；p<0.001）在应答者和非应答者组之间存在显着差异。接收器操作员特征分析显示NLR（AUC0.778；95%CI0.669-0.864），PLR（AUC0.628；95%CI0.511-0.735），MLR（AUC0.653；95%CI0.536-0.757），和SII（AUC0.709；95％CI0.595-0.806）可能是DME和NPDR患者对贝伐单抗反应的预测因子。严重NPDR患者的ApoB/ApoA-I比率明显较高（0.70（0.57-0.87）与0.61（0.49-0.72），p=0.049）和较低的维生素D（52.45（43.10-70.60）ng/mL与40.05(25.95-55.30)ng/mL,p=0.025)。NLR的改变，PLR,MLR,和SII似乎提供了有关DME患者对贝伐单抗反应的预后信息，而维生素D缺乏和ApoB/ApoA-I比率可能有助于更好的分期。
