Assessment of Globulin Levels and Albumin-to-globulin Ratio in Patients with Type 2 Diabetes and Retinopathy: A Retrospective Single-center Study

The Open Ophthalmology Journal 08 December 2023 RESEARCH ARTICLE DOI: 10.2174/0118743641277168231201102545



Diabetes is a global health burden, with diabetic retinopathy (DR) repeatedly arising as an inflammatory complication. This study aims to evaluate routine blood measures as inflammatory markers in DR.


A cross-sectional study was conducted on patients with type 2 diabetes (T2D) attending an outpatient clinic at a tertiary care hospital. Data on glycated hemoglobin (HbA1c), C-reactive protein (CRP), total protein, albumin, and globulin were retrospectively collected from medical records. Data analysis involved independent t-tests, Mann-Whitney, and Pearson's correlation.


Encrypted data were collected and analyzed for 139 diabetic patients (70 DR, 69 non-DR). The mean globulin levels were significantly higher in the DR group compared to the non-DR group (30.1g/L±5.04 and 18g/L±9.14, respectively, p<0.001). Moreover, the DR group had a lower mean albumin-to-globulin ratio than the non-DR group (1.3±0.33 and 2.8±2.06, respectively, p<0.001) and a higher mean HbA1c level (8±1.49 and 7.4±1.58, respectively, p=0.020). A weak negative correlation between globulin and albumin levels was detected, with a Pearson's correlation coefficient of -0.085 (p=0.482). Mean values of total protein, albumin, and CRP differed between groups but were not statistically significant (p=0.133, 0.763, 0.396 respectively).


The study highlights the potential use of routine blood biomarkers as useful indicators for DR in T2D. The observed increase in serum globulin levels and the negative correlation with albumin provide important insights into the pathophysiology of DR. However, further research is necessary to elucidate the mechanisms behind these associations and evaluate the clinical usefulness of these biomarkers.

Keywords: Diabetic retinopathy, Blood biomarkers, Globulin, Albumin-to-globulin ratio, Glycated hemoglobin (HbA1c), Diabetes, Mellitus.
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