The multivariable-adjusted (age, sex, diabetes course, smoking history, drinking history, BMI, SBP, TG, HbA1c, FBG, fasting insulin, uric acid, eGFR, and UACR) hazard ratios (HRs) for incident DR across ascending NLR quartiles (≤1.46 [reference], 1.47–1.90, 1.91–2.45 and > 2.45) were 1.000, 1.327 (95% confidence interval [CI] 0.754–2.334), 1.555 (95% CI 0.913–2.648) and 2.217 (95% CI 1.348–3.649), respectively (P=0.011) (Table 2). This evidence concerns the gene INS and diabetes mellitus.