Neutrophil-to-Lymphocyte Ratio, Lipid Profile, and Diabetic Peripheral Neuropathy Risk: Mediation and Synergy in a...

Area of Science:

• Endocrinology
• Neurology
• Cardiology

Background:

• Diabetic peripheral neuropathy (DPN) is often underdiagnosed in primary care settings.
• Systemic inflammation and lipid abnormalities are implicated in DPN pathogenesis.

Purpose of the Study:

• To investigate the mediating and synergistic roles of lipid profile components and systemic inflammation (neutrophil-to-lymphocyte ratio, NLR) in relation to DPN.
• To assess the combined impact of elevated NLR and dyslipidemia on DPN risk.

Main Methods:

• Cross-sectional study in Indonesia with 738 participants.
• Data collection included questionnaires, laboratory tests (lipid profile, NLR), and sensory screening (Semmes-Weinstein monofilament, tuning fork).
• Multivariate logistic regression and path analysis were used to evaluate associations and mediation effects.

Main Results:

• Increased NLR (AOR 8.39), total cholesterol (AOR 3.10), and LDL-C (AOR 2.25) were independently associated with higher DPN risk.
• Combined abnormalities of NLR and lipids markedly amplified DPN risk (AOR 33.30).
• Path analysis indicated partial mediation of the NLR-DPN association by LDL-C and total cholesterol.

Conclusions:

• NLR and lipid profile components are significant contributors to DPN risk, with synergistic effects observed.
• Integrating NLR and lipid monitoring into routine foot screening in primary care can improve early DPN detection and risk stratification.
• This approach supports targeted interventions to prevent DPN-related disability and enhance diabetes management.