ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1602361
This article is part of the Research TopicUnderstanding the Impact of Obesity on Micronutrient MetabolismView all articles
Nutritional-Inflammatory Status and Diabetic Retinopathy: Exploring the Association Between Advanced Lung Cancer Inflammation Index and Retinal Complications in Diabetes
Provisionally accepted
- 1Hubei Enshi College, Enshi, Hubei Province, China
- 2Department of Cardiovascular Medicine, Fifth People's Hospital of Jinan, Jinan, China
- 3Enshi Central Hospital, Enshi, China
- 4The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: This study aimed to assess the association between the Advanced Lung Cancer Inflammation Index (ALI) and the prevalence of diabetic retinopathy (DR) in a nationally representative sample of U.S. adults with diabetes.We used cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2018. ALI was calculated from the body mass index (BMI), albumin levels, and neutrophil-to-lymphocyte ratio (NLR), providing an integrative measure of inflammatory and nutritional metabolic status. A history of diabetes was obtained through self-report. Logistic regression models were used to investigate the relationship between ALI and DR prevalence, adjusting for multiple potential confounders. Additionally, restricted cubic spline (RCS) analyses were used to explore potential nonlinear associations.Results: A total of 3,952 diabetic participants were included, of whom 813 had DR. Logistic regression analysis shows that higher ALI values are significantly correlated with a decrease in DR prevalence. Compared to the lowest ALI quartile, the highest quartile was associated with a 27% decrease in DR prevalence after full adjustment.Subgroup analyses showed that the relationship remained stable across most demographic and clinical strata, although racial differences were also observed. Furthermore, RCS analyses revealed an L-shaped relationship between ALI and DR prevalence.In the U.S. adult diabetic population, lower ALI levels were associated with greater DR prevalence, and this relationship displayed an L-shaped, non-linear pattern. These findings suggest that monitoring and managing ALI may be beneficial in reducing the risk of DR. Future longitudinal studies are needed to clarify the causality and evaluate the impact of ALI-targeted interventions in clinical practice.
Keywords: Advanced lung cancer inflammation index, Diabetic Retinopathy, Inflammation, nutrition, Metabolic health, NHANES, Non-linear association
Received: 29 Mar 2025; Accepted: 05 Jun 2025.
Copyright: © 2025 Peng, Chen, Wang, Wang, Wu and Xiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Feng Wu, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China
Jianjun Xiang, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.