Abstract:AIM: To evaluate the diagnostic value of serum cyclooxygenase-2(COX-2)and receptor for advanced glycation end products(RAGE)for diabetic retinopathy(DR)in type 2 diabetes mellitus(T2DM)patients.METHODS:From January 2022 to August 2024, 118 T2DM patients(118 eyes)with DR who visited our department were taken as DR group, while 75 T2DM patients(75 eyes)without DR were included as T2DM group. Another 50 healthy adults(50 eyes)who underwent physical checkups were included as the control group. Enzyme-linked immunosorbent assay was applied to detect and compare serum levels of COX-2 and RAGE. Logistic regression was applied to explore the factors that affected the occurrence of DR in T2DM patients. The receiver operating characteristic(ROC)curve was applied to evaluate the value of serum COX-2 and RAGE in diagnosing DR in T2DM patients.RESULTS:For the control group and T2DM group, the serum COX-2 and RAGE in the DR group were obviously higher, and with the T2DM group being higher than the control group(all P<0.05). Compared with the T2DM group, the DR group had a longer duration of T2DM, higher glycosylated hemoglobin and fasting blood glucose, and a higher proportion of hypertension history(all P<0.05). Long duration of T2DM, hypertension history, and elevated levels of glycosylated hemoglobin, COX-2, and RAGE were risk factors for DR in T2DM patients(all P<0.05). The AUC of serum COX-2, RAGE, and their combined diagnosis for DR in T2DM patients was 0.828, 0.819, and 0.907, respectively. The combined diagnosis was superior to the individual detection(Zcombination-COX-2=3.220, P=0.001; Zcombination-RAGE=2.734, P=0.006).CONCLUSION:Serum COX-2 and RAGE are obviously elevated in T2DM with DR, and they have high clinical application value for diagnosing T2DM patients with DR.