Association between red blood cell distribution width‐to‐albumin ratio and diabetic retinopathy

Diabetes mellitus (DM) has shown a trend of reaching pandemic levels in the world. Chronic inflammation is a key factor in the development of diabetic retinopathy (DR). Red blood cell distribution width-to-albumin ratio (RA) is used to assess immune status and the immune response. Our study was conducted to assess the association between DR and RA levels to determine the value of RA in predicting DR.The data came from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2006, The RA was calculated as the Red Blood Cell Distribution Width/Albumin Ratio. Multivariable logistic regression and propensity score-matched analysis were used to examine the association between RA and DR levels.The clinical and demographic features of the 1,751 patients with DM. The eligible participants included 874 females and 870 males with mean age 62.2 ± 14.0 years, and mean RA 3.2 ± 0.5. RA ≥ 2.9659 was a risk factor for DR (OR = 1.66 95% CI: 1.31-2.11, p < 0.0001). After adjusting for age, sex, race, education, marital status, ratio of family income to poverty, body mass index, fasting glucose, hypertension, and coronary heart disease, RA ≥ 2.9659 was an independent risk factor for DR (OR = 1.64, 95% CI: 1.23-2.19, p = 0.0008). The propensity score-matched analysis also showed that high RA was an independent risk factor for DR.Our study shows that RA is a risk factor for patients with DR. The findings of this study should be validated the role of RA in DR in diabetic patients.