Combined serum neurofilament light chain and Tau as biomarkers of diabetic peripheral neuropathy

Background: To assess the diagnostic performance of combined serum neurofilament light chain (NfL) and Tau protein measurement in detecting diabetic peripheral neuropathy (DPN). Methods: We retrospectively analyzed 50 patients with DPN and 50 age- and sex-matched Non-DPN treated between December 2023 and May 2024. Serum NfL and Tau were measured by ELISA assays. Logistic regression identified factors associated with DPN, and receiver operating characteristic (ROC) curves assessed diagnostic performance. Results: Compared with controls, DPN patients had longer diabetes duration, higher blood pressure, BMI, and HbA1c, and lower motor and sensory nerve conduction velocities (all P < 0.05). Serum NfL and Tau were significantly elevated in the DPN group (P < 0.001). Multivariate logistic analysis showed diabetes duration, systolic blood pressure, and elevated NfL and Tau were independently associated with DPN. ROC analysis revealed AUCs of 0.825 for Tau, 0.829 for NfL, and 0.896 for their combination, with combined detection achieving sensitivity of 93.9% and specificity of 82.4%. Conclusions: Elevated serum NfL and Tau levels are independently associated with DPN. The combined assessment may provide a complementary, non-invasive approach for preliminary screening and risk stratification of diabetic peripheral neuropathy.