# Associations between the monocyte‑lymphocyte ratio and age‑related macular degeneration among US adults: evidence from NHANES 2005–2008

**Authors:** Zhanhe Zhang, Hongli Yang, Liangzhang Tan, Yongtao Li, Xinjun Ren, Xiaorong Li

PMC · DOI: 10.1186/s40942-025-00766-2 · 2025-11-28

## TL;DR

This study finds that higher monocyte-to-lymphocyte ratios are linked to an increased risk of age-related macular degeneration in US adults.

## Contribution

The study is the first to explore the association between MLR and AMD using NHANES data.

## Key findings

- MLR was significantly higher in AMD patients compared to non-AMD individuals.
- Elevated MLR was associated with a 2.56-fold increased risk of AMD after adjusting for confounders.
- ROC analysis showed MLR has acceptable discrimination for AMD.

## Abstract

Previous studies have established an association between age-related macular degeneration (AMD) and chronic systemic inflammation. However, the relationship between AMD and the monocyte-to-lymphocyte ratio (MLR), a novel inflammatory biomarker, remains unclear. In this study, we aimed to investigate the association between MLR and AMD using data from the 2005–2008 National Health and Nutrition Examination Survey (NHANES).

Data from three NHANES cycles (2005–2008) were analyzed to preliminarily assess the association between MLR and AMD, excluding participants with incomplete data. We utilized weighted logistic regression models, restricted cubic spline functions (RCS) and constructed receiver operating characteristic (ROC) curves to evaluate the association between MLR and AMD.

A total of 4,894 participants were deemed eligible for our analysis, with 379 individuals diagnosed with AMD. The Monocyte to Lymphocyte Ratio (MLR) was significantly elevated in the AMD group compared to the non-AMD group. After adjusting for potential confounding factors, we found that elevated MLR levels were significantly associated with an increased risk of AMD, with an OR of 2.56, 95% CI: (1.17,5.58), P = 0.022. The restricted cubic spline (RCS) analysis revealed a significant nonlinear relationship between MLR and AMD, with an inflection point at 0.26 (nonlinear P < 0.05). Furthermore, the receiver operating characteristic (ROC) curve analysis demonstrated that MLR exhibited acceptable discrimination for AMD.

Elevated MLR is associated with an increased risk of AMD, suggesting that MLR may serve as a simple and effective clinical biomarker of AMD.

## Linked entities

- **Diseases:** age-related macular degeneration (MONDO:0005150), AMD (MONDO:0005150)

## Full-text entities

- **Diseases:** AMD (MESH:D008268), chronic systemic inflammation (MESH:D007249)

## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12765317/full.md

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Source: https://tomesphere.com/paper/PMC12765317