Discriminative Performance of the Combined MoCA/MMSE and NPAR for Type 2 Diabetes Mellitus-related Peripheral Neuropathy

Yanzhen ZHANG; Li SHI; Lingyan YUAN; Hongying NIU; Peixin TIAN; Yushan XU

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Yanzhen ZHANG, Li SHI, Lingyan YUAN, Hongying NIU, Peixin TIAN, Yushan XU. Discriminative Performance of the Combined MoCA/MMSE and NPAR for Type 2 Diabetes Mellitus-related Peripheral Neuropathy[J]. Journal of Kunming Medical University.

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Discriminative Performance of the Combined MoCA/MMSE and NPAR for Type 2 Diabetes Mellitus-related Peripheral Neuropathy

1.
Department of Endocrinology，The First Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032
2.
Department of Endocrinology，The First People's Hospital of Luliang County，Qujing Yunnan 650600，China

Received Date: 2026-05-15

Abstract

Abstract

Objective To investigate the associations of the Montreal Cognitive Assessment （MoCA）, Mini-Mental State Examination （MMSE）, and neutrophil percentage-to-albumin ratio （NPAR） with diabetic peripheral neuropathy （DPN）, as well as their discriminative performance. Methods A total of 171 patients with type 2 diabetes mellitus who visited the Department of Endocrinology at the First People's Hospital of Luliang County from July to November 2025 were recruited. According to the presence or absence of DPN, patients were divided into a diabetic peripheral neuropathy（DPN） group（n = 79）and the non-DPN group. Basic demographic data and laboratory results were collected, and MoCA and MMSE scores were assessed. Associations were analyzed using LASSO and logistic regression, and receiver operating characteristic （ROC） curves were plotted to evaluate the discriminative performance of relevant indicators for DPN. Results MoCA（OR = 0.857, 95%CI 0.807～0.910, P < 0.001） and MMSE（OR = 0.824, 95%CI 0.761-0.892, P < 0.001） scores were negatively associated with the risk of DPN, whereas NPAR was positively associated with the risk of DPN（OR = 1.020, 95%CI 1.008-1.032, P < 0.001）. Regarding discriminative performance, MoCA （AUC=0.7477, 95%CI: 0.6741～0.8213） was comparable to MMSE （AUC=0.7477, 95%CI: 0.6720～0.8188; DeLong test, P = 0.911）, although MoCA had higher specificity and MMSE had higher sensitivity. Compared with the basic clinical model （AUC=0.786, 95%CI: 0.718～0.8539）, the MoCA+NPAR model （AUC=0.8254, 95%CI: 0.7636～0.8872） and the MMSE+NPAR model （AUC=0.8235, 95%CI: 0.7606～0.8863） showed significantly improved discriminative performance （DeLong test, P < 0.05）. The combined MoCA+MMSE+NPAR model had discriminative performance comparable to that of the MoCA+NPAR model （DeLong test, P > 0.05）. Conclusions MoCA, MMSE, and NPAR are associated with the risk of DPN. Combining either MoCA or MMSE with NPAR can effectively improve the discriminative performance for DPN.

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References(31)

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