Evaluation of the triglyceride-glucose index, serum inflammatory biomarkers and lipid profile in patients with neovascular age-related macular degeneration

Purpose: To evaluate the triglyceride–glucose index (TyG), novel systemic inflammatory biomarkers, and lipid profile in patients with neovascular age-related macular degeneration (nAMD), and to investigate their potential relationship with disease presence. Methods: This retrospective case–control study included 59 patients diagnosed with nAMD and 67 age- and sex-matched healthy controls. Demographic characteristics, fasting biochemical tests, lipid profile, complete blood count, and serum inflammatory indices were recorded. Triglyceride–glucose index, systemic inflammatory indices derived from various hematological parameters and lipid levels were calculated. Laboratory parameters and calculated indexes were compared between the two groups using Statistical Package for the Social Sciences (SPSS). Results: Triglyceride–glucose index was significantly higher in the nAMD group than in controls (4.84 ± 0.27 vs. 4.69 ± 0.17, p = 0.0001). Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels were also elevated in the nAMD group (p = 0.0001 for both). Among hematological markers, white blood count (WBC), neutrophil, and monocyte counts were significantly increased in nAMD patients (p = 0.012, p = 0.001, p = 0.015, respectively). Inflammatory indices including neutrophil/lymphocyte ratio (NLR) (p = 0.015), monocyte/HDL-C ratio (MHR) (p = 0.003), systemic inflammation aggregate index (AISI) (p = 0.025), and C reactive protein/albumine ratio (CAR) (p = 0.006) were significantly higher in the nAMD group, whereas the systemic immune inflammation index (SII), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) showed no significant differences (p > 0.05). Serum lipid levels and atherogenic lipid ratios did not differ between the groups. Discussion: Patients with nAMD exhibit increased systemic inflammatory activity and metabolic stress, reflected by elevated NLR, MHR, AISI, and CAR levels. In addition, TyG, a novel indicator of systemic insulin resistance, was found to be elevated in nAMD patients. These findings suggest that metabolic dysregulation and chronic low-grade systemic inflammation may contribute to nAMD pathogenesis independently of serum lipid levels. The TyG and inflammation-derived biomarkers may serve as potential systemic indicators for nAMD risk or disease activity.