AIM:To explore the serum retinol binding protein 4(RBP4), inflammatory index neutrophil to lymphocyte ratio(NLR), platelet to lymphocyte ratio(PLR)in patients with type 2 diabetes mellitus(T2DM)after diabetic retinopathy(DR)levels and factors affecting the occurrence of DR in patients. METHODS: The clinical data of 142 patients with T2DM who reached the standard of blood glucose control in our hospital from February 2017 to February 2020 were analyzed retrospectively. According to the results of fundus angiography, the patients were divided into Normal group(n=74), NPDR group(n=36)and PDR group(n=32). Compared the general data and blood test indexes of the three groups, and analyzed the factors affecting the occurrence of DR by multivariate Logistic regression analysis. Constructed a line chart prediction model to predict the occurrence of DR and evaluated its predictive efficiency. RESULTS: The course of DM, serum GH, IGF-I, LDL-C, UA, RBP4, NLR and PLR in PDR group were significantly higher than those in Normal group and NPDR group, while C-P and 2h C-P were significantly lower than those in Normal group and NPDR group. The course of disease >12a, IGF-I >145μg/L, C-P <0.75ng/mL, UA >245ng/mL, RBP4 >54mg/L, NLR >1.8 and PLR >110 were independent risk factors for DR. The line chart model has high degree of differentiation and calibration, and has good prediction efficiency. CONCLUSION: In addition to the common risk factors such as the course of DM, IGF-I, C-P and UA, the increase of RBP4, NLR and PLR is also related to DR, which may be involved in the occurrence and development of DR.