Objective  To explore the related risk factors of comorbid diabetes mellitus in patients with aqueous deficiency dry eye.

Methods  Patients with aqueous deficiency dry eye who were admitted to Zhongnan Hospital of Wuhan University from August 2022 to August 2024 were selected as the research subjects. They were divided into the diabetes mellitus combined with dry eye group and the dry eye group based on whether they had diabetes. The age, gender, body mass index (BMI), number of peripheral blood neutrophils, lymphocytes, and platelets were collected for both groups. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) were calculated. Univariate analysis and multivariate Logistic regression analysis were performed between the two groups, and a nomogram was constructed to predict the risk of diabetes mellitus in patients with aqueous deficiency dry eye.

Results  A total of 150 patients with aqueous deficiency dry eye were enrolled, including 74 patients in the diabetes mellitus combined with dry eye group and 76 patients in the dry eye group. The results of univariate analysis showed that there were statistically significant differences in BMI, number of neutrophils, lymphocytes, platelets, NLR, PLR, and SII between the two groups (P<0.05). The results of multivariate Logistic regression analysis showed that BMI (OR=1.176, 95%CI: 1.026-1.349), NLR (OR=6.575, 95%CI: 2.772-15.598), and PLR (OR=1.030, 95%CI: 1.012-1.047) were independent risk factors for diabetes mellitus in patients with aqueous deficiency dry eye. A nomogram for predicting the risk of diabetes mellitus in patients with aqueous deficiency dry eye was successfully developed and a receiver operating characteristic (ROC) curve was drawn to verify the accuracy of the model (AUC=0.872, specificity=93.40%, sensitivity=64.90%).

Conclusion  BMI, NLR and PLR were predictors of the risk of diabetes in patients with aqueous deficiency dry eye. The nomogram developed based on them had good predictive value for the risk of diabetes mellitus in patients with aqueous deficiency dry eye. NLR, PLR and SII can be used as new biomarkers to reflect the immune and inflammatory status of patients with the comorbidity of diabetes and dry eye.

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