{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T03:27:38Z","timestamp":1783999658609,"version":"3.55.0"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing &amp;amp; Health Sciences"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Diabetic peripheral neuropathy (DPN) remains under\u2010detected in primary care despite available bedside tests and laboratory markers. We assessed whether lipid profile components mediate and synergize with systemic inflammation, indexed by the neutrophil\u2010to\u2010lymphocyte ratio (NLR), in relation to DPN. In a cross\u2010sectional study in Indonesia (July 2023\u2013January 2024), 738 participants completed questionnaires, laboratory testing, and sensory screening with a 10\u2010g Semmes\u2013Weinstein monofilament and 128\u2010Hz tuning fork. Multivariate logistic regression showed that an abnormally increased NLR (AOR 8.39;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), total cholesterol (AOR 3.10;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and LDL\u2010C (AOR 2.25;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) were independently associated with a higher DPN risk. Combined abnormalities markedly amplified the risk (AOR 33.30;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Path analysis supported partial mediation of the NLR\u2010DPN association via LDL\u2010C and total cholesterol (total indirect\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u20090.03; 95% CI 0.02\u20130.05;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Integrating NLR and lipid monitoring with routine foot screening in nurse\u2010led primary care may enable earlier identification and risk stratification, particularly among individuals with longer duration or suboptimal glycemic control, thereby supporting targeted education and prevention to reduce disability and advance diabetes care.\n                  <\/jats:p>","DOI":"10.1111\/nhs.70306","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T05:08:46Z","timestamp":1771304926000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Neutrophil\u2010to\u2010Lymphocyte Ratio, Lipid Profile, and Diabetic Peripheral Neuropathy Risk: Mediation and Synergy in a Community\u2010Based Cross\u2010Sectional Study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3336-3276","authenticated-orcid":false,"given":"Siti","family":"Fadlilah","sequence":"first","affiliation":[{"name":"School of Nursing, College of Nursing Taipei Medical University  Taipei Taiwan, ROC"},{"name":"Program Study of Nursing Universitas Respati Yogyakarta  Yogyakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3528-876X","authenticated-orcid":false,"given":"Tri Budi Wahyuni","family":"Rahardjo","sequence":"additional","affiliation":[{"name":"Universitas Respati Indonesia  Jakarta Indonesia"},{"name":"Center for Family and Ageing Studies Universitas Respati Indonesia  Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7052-6516","authenticated-orcid":false,"given":"Hari","family":"Kusnanto","sequence":"additional","affiliation":[{"name":"Department of Public Health Universitas Respati Yogyakarta  Yogyakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5031-4997","authenticated-orcid":false,"given":"Sumarni","family":"Sumarni","sequence":"additional","affiliation":[{"name":"Program Study of Nursing Poltekkes Kemenkes  Semarang Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2721-9427","authenticated-orcid":false,"given":"Jia Ruey","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Taipei Medical University  Taipei Taiwan, ROC"},{"name":"Taipei Cancer Center Taipei Medical University Hospital  Taipei Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9371-1025","authenticated-orcid":false,"given":"Wei\u2010Jun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Taipei Medical University Hospital  Taipei Taiwan, ROC"},{"name":"Proton Center Taipei Medical University Hospital, Taipei Medical University  Taipei Taiwan, ROC"},{"name":"Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University  Taipei Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1137-9274","authenticated-orcid":false,"given":"Hsiu Ting","family":"Tsai","sequence":"additional","affiliation":[{"name":"School of Nursing, College of Nursing Taipei Medical University  Taipei Taiwan, ROC"},{"name":"Post\u2010Baccalaureate Program in Nursing College of Nursing, Taipei Medical University  Taipei Taiwan, ROC"},{"name":"Center of Excellence for Enhancing Well\u2010Being in Vulnerable and Chronic Illness Populations, Faculty of Nursing Chulalongkorn University  Bangkok 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