The Relationship between CRP-TyG,MAR and Diabetic Retinopathy in Type 2 Diabetes Mellitus

WANG Xue; ZHANG Yixin; HUANG Xing; ZHOU Qi; ZHENG Shuhong; GAO Weiping; WU Huijuan; LIANG Ge

doi:10.3639/j.issn.2095-3097.2025.04.020

Abstract：Objective To analyze the relationship between C-reactive protein-triglyceride-glucose index(CRP-TyG)and monocyte-to—apolipoprotein A1 ratio(MAR)in patients with diabetic retinopathy(DR)complicating type 2 diabetes melli-tus(T2DM).Methods A total of 222 T2DM patients treated at the Rocket Force Medical Center from September 2021 to Sep-tember 2024 were stratified into non-DR(T2DM group,n=124)and DR(DR group,n=98)cohorts.Clinical parameters including fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),insulin resistance index(HOMA-IR),triglycerides(TG),total cholesterol(TC),high-density lipoprotein(HDL),low-density lipoprotein(LDL),and C-reactive protein(CRP)were analyzed.CRP-TyG and MAR were calculated.Receiver operating characteristic(ROC)curves assessed diagnostic performance,with multivariate logistic regression identifying independent risk factors.Results The DR group showed significantly longer T2DM and higher FBG,HbA1c,HOMA-IR,monocyte coun,TC,TG,CRP,and TyG index compared to the non-DR group(P＜0.05),HDL and ApoA1 levels were significantly lower(P＜0.05).CRP-TyG and MAR levels were elevated in DR patients(P＜0.05).ROC curve demonstrated combined CRP-TyG/MAR AUC=0.909,surpassing individual markers(CRP-TyG AUC=0.835;MAR AUC=0.857;Z=6.254 and 8.441,P＜0.001).Multivariate analysis revealed T2DM duration≥5.86 years(OR=2.710,95％CI:1.799-4.082),HOMA-IR ≥3.11(OR=3.001,95％CI:1.817-4.957),CRP-TyG ≥5.46(OR=4.195,95％CI:2.044-8.613),and MAR≥3.26(OR=3.435,95％CI:1.867-6.319)as independent predictors(P＜0.05).Conclusion Elevated CRP-TyG and MAR levels are associated with DR in T2DM.Combined assessment demonstrates superior diagnostic accuracy compared to in-dividual biomarkers,supporting clinical decision-making.