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This research aims to determine how effectively the fibrinogen-to-high-density lipoprotein cholesterol ratio predicts sub-clinical diabetic peripheral neuropathy in type 2 diabetes patients.

April 24, 2026Frontiers in Aging Neuroscience0 citationsOpen Access

Predictive value of the fibrinogen-to-high-density lipoprotein cholesterol ratio for sub-clinical diabetic peripheral neuropathy in type 2 diabetes mellitus

YWYanmei Wang FHFan Hu JLJie Li

Key Points

This research aims to determine how effectively the fibrinogen-to-high-density lipoprotein cholesterol ratio predicts sub-clinical diabetic peripheral neuropathy in type 2 diabetes patients.
Analyzed clinical profiles, inflammatory biomarkers, nerve conduction velocities, and current perception thresholds in patients with type 2 diabetes mellitus.
Conducted logistic regression analyses to identify risk factors for sub-clinical diabetic peripheral neuropathy.
Used ROC curve analysis to assess the predictive performance of the fibrinogen-to-HDL cholesterol ratio among patients.
Patients with sub-clinical diabetic peripheral neuropathy had significantly higher fibrinogen levels and lower HDL cholesterol levels compared to those without sDPN.
The fibrinogen-to-HDL cholesterol ratio had an area under the curve of 65%, indicating moderate predictive capability.
The model incorporating the fibrinogen-to-HDL ratio improved risk classification over basic models (NRI = 0.416, p = 0.001).

Abstract

Introduction This study aims to investigate the predictive value of the fibrinogen-to-high-density lipoprotein cholesterol ratio (FHR) in relation to sub-clinical diabetic peripheral neuropathy (sDPN) in individuals diagnosed with type 2 diabetes mellitus (T2DM). Methods A cohort of 281 patients with T2DM was admitted to the Neurology Department of Jiangxi Provincial People’s Hospital between January and December 2023. Within this population, 148 patients were diagnosed with sDPN. The clinical profiles, inflammatory biomarkers, and nerve conduction velocities or current perception thresholds (CPTs) were compared between the two distinct groups. A logistic regression analysis was performed to identify the risk factors for sDPN. The predictive performance of each factor was assessed using a receiver operating characteristic (ROC) curve analysis. The FHR was compared among three groups, which were based on the severity of peripheral neuropathy (PN). Results Patients with sDPN exhibited significantly elevated levels of fibrinogen (FIB), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), the monocyte-to-lymphocyte ratio (MLR), and the platelet-to-lymphocyte ratio (PLR), along with diminished high-density lipoprotein cholesterol (HDL-C) levels, compared to patients without sDPN. Univariate and multivariate logistic regression analyses indicated that age, FIB levels, HbA1c, HDL-C, and MLR were significant risk factors that contributed to the onset of sDPN in T2DM patients. The ROC curve analysis indicated that the FHR had an area under the curve (AUC) of 65%. The optimal cutoff value for the FHR was 2.65, exhibiting a specificity of 62.4% and a sensitivity of 63.5%. The composite model incorporating the FHR demonstrated superior reclassification performance (net reclassification improvement (NRI) = 0.416, p = 0.001, 95% CI 0.180–0.650) and integrated discrimination improvement (IDI = 0.053, p 0.001, 95% CI 0.001–0.015) compared to the basic model (age +HbA1c + MLR). Nonparametric test analysis showed significant differences in the FHR among the three groups. The more severe the PN, the higher the FHR. Conclusion The FHR may serve as a valuable early diagnostic marker for sDPN in T2DM.

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