Correlation between lipoprotein-associated phospholipase A2 and diabetic peripheral neuropathy in patients with type 2 diabetes mellitus: A cross-sectional study

Background: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an enzyme implicated in inflammation and oxidative stress, and has been associated with cardiovascular conditions and adverse outcomes, particularly in diabetes and its complications. However, no prior studies have examined the relationship between Lp-PLA2 and diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus (T2DM). This research aims to explore the potential association between Lp-PLA2 and DPN. Methods: This retrospective study included 880 hospitalized patients with T2DM treated between March 2024 and August 2024 at Nanjing First Hospital. To assess the relationship between Lp-PLA2 and DPN, multiple logistic regression models were applied. The study also utilized restricted cubic spline (RCS) modeling, segmented regression, stratified analysis, and receiver operating characteristic (ROC) curve assessments. Results: Patients diagnosed with DPN exhibited elevated Lp-PLA2 levels compared to those without DPN. Even after adjusting for multiple variables, Lp-PLA2 was independently associated with a higher likelihood of DPN (odds ratio [OR] 1.011, 95 % confidence interval [CI] 1.008-1.014, P < 0.001). The RCS analysis revealed a nonlinear association, with an inflection point at 215.8 ng/mL. In ROC curve analysis, the area under the curve (AUC) for Lp-PLA2 was 0.664, while the combined indicator AUC was 0.739. Conclusions: Serum Lp-PLA2 levels show a significant correlation with the presence of DPN in patients with T2DM. These findings suggest that Lp-PLA2 could serve as a valuable biomarker for identifying patients at risk for DPN, emphasizing the need for close monitoring of T2DM individuals with elevated Lp-PLA2 to mitigate the risk of developing DPN and associated adverse health outcomes.