The association between Apolipoprotein A1 , Apolipoprotein B and their ratio with diabetes‐related neuropathy in elderly patients

Background Diabetes‐related neuropathy is a prevalent microvascular complication among elderly individuals with type 2 diabetes mellitus (T2DM). Apolipoprotein A1 (ApoA1) and Apolipoprotein B (ApoB) play opposing roles in lipid metabolism, and the ApoB/ApoA1 ratio has emerged as a sensitive marker of cardiometabolic risk. This study aimed to examine the association between ApoA1, ApoB and the ApoB/A1 ratio with the presence of diabetes‐related neuropathy as indicated by MNSI scores. Methods A cross‐sectional study was conducted on 63 T2DM patients aged ≥60 years. Neuropathy was assessed using the Michigan Neuropathy Screening Instrument (MNSI), while ApoA1 and ApoB levels were measured via turbidimetry. Comparative and correlational analyses were performed to explore relationships between apolipoproteins, neuropathy status, HbA1c and lipid profiles. Results Diabetes‐related neuropathy was identified in 55.6% of participants. ApoB and the ApoB/A1 ratio were significantly elevated in subjects with neuropathy ( p = 0.015 and p = 0.014, respectively), while ApoA1 levels did not differ significantly ( p = 0.172). MNSI scores were positively correlated with ApoB ( r = 0.426; p < 0.001) and ApoB/A1 ratio ( r = 0.431; p < 0.001), but not with ApoA1. HbA1c showed positive correlations with ApoB and the ratio and a negative correlation with ApoA1. Conclusion Elevated ApoB and ApoB/A1 ratio are significantly associated with diabetes‐related neuropathy in elderly T2DM patients. The ApoB/A1 ratio may serve as a valuable biomarker for identifying individuals at higher risk of neuropathic complications.