LDL/HDL ratio and HOMA-IR as markers of severity of peripheral neuropathy in diabetic population

Objective. Diabetic peripheral neuropathy (DPN) is a common complication of type 2 diabetes mellitus (T2DM) that substantially impairs quality of life. This study aimed to assess the relationship between metabolic parameters and DPN severity in T2DM patients. Methods. A prospective observational study was conducted at PSG Institute of Medical Sciences and Research (Peelamedu, Coimbatore, India) from August 2023 to August 2024, enrolling 90 adults with T2DM on oral hypoglycemic agents after ethical approval and informed consent. Blood samples were analyzed for fasting glucose, HbA1c, lipid profile, and plasma insulin. The LDL/HDL ratio and HOMA-IR were calculated to evaluate metabolic status. DPN severity was measured using a biothesiometer. Results. The higher HbA1c levels significantly correlated with increased neuropathy severity (severe: 12.1±1.3% vs. mild: 8.4±2.0%; p=0.002). LDL/HDL ratio was elevated in patients with severe DPN (3.6±1.8) compared to mild DPN cases (2.5±1.0), but this difference was not significant (p=0.12). Severe DPN cases also showed higher HOMA-IR (10.2±2.8) suggesting a possible link to insulin resistance though not statistically significant (p=0.23). Conclusion. HbA1c strongly associates with DPN severity, while LDL/HDL ratio and HOMAIR showed no significant correlation. Further research is needed to clarify these metabolic relationships and their clinical relevance.