Abstract
Objective: Investigating the connections between diabetic foot ulcer infection patients' prognosis and disease severity, we measured serum adiponectin (APN), D-dimer (D-D), and the neutrophil-to-lymphocyte ratio (NLR).
Methods: A total of 292 patients with diabetic foot ulcer infection admitted to our hospital from February 2024 to February 2025 were selected and divided into mild (n=95), moderate (n=139) and severe (n=58) patients according to the severity of the disease. The levels of serum APN, D-D and the NLR in patients with different severity levels were compared. To analyze serum APN, D-D and the NLR, patients were followed up for one year, and the prognoses of the patients were statistically analyzed.
Results: Comparisons of the serum APN, D-D and NLR levels among patients with different severity, and the serum APN levels in moderate conditions were lower than those in patients with mild conditions (P<0.05). The serum APN of severe patients was 5.35±0.98, and that of moderate patients was 7.64±1.25, which was lower than that of mild patients (9.19±1.73; P<0.05), and the serum APN level of severe patients was lower than that of moderate patients (P<0.05). Comparisons of the serum D-D and NLR levels revealed that the serum D-D and NLR in severe patients were 3.49±0.72 and 2.86±0.58, respectively, and those in moderate patients were 3.02±0.63 and 2.24±0.46, respectively, both of which were greater than those in mild patients, which were 2.43±0.51 and 1.71±0.33 (P<0.05). The levels of serum D-D and the NLR were greater in severe patients than in moderate patients (P<0.05). According to Spearman correlation analysis, the severity of the disease in diabetic foot ulcer infection patients was positively connected with the serum D-D level and NLR (r=0.387, P<0.001; r=0.461, P<0.001) and negatively connected with the serum APN level (r=-0.414, P<0.001). ROC analysis revealed that the optimal cutoff values of the serum APN, D-D and NLR for predicting poor prognosis in patients were 5.73 mg/L, 3.06 mg/L and 2.12, respectively; the sensitivities were 78.57%, 82.14% and 85.71%, respectively; and the specificities were 76.56%, 67.19% and 73.44%, respectively. The areas under the curve (AUCs) were 0.793, 0.784, and 0.818, respectively. The specificity and AUC of the combination of the three methods were 98.44% and 0.918, respectively.
Conclusion: Serum APN and D-D levels and the NLR in patients with diabetic foot ulcer infection are related to disease severity. The serum APN, D-D and NLR can be used as sensitive indicators for predicting poor patient prognosis.
Keywords
Array
Array
Array
References
The published articles will be distributed under the Creative Commons Attribution 4.0 International License (CC BY). It is allowed to copy and redistribute the material in any medium or format, and remix, transform, and build upon it for any purpose, even commercially, as long as appropriate credit is given to the original author(s), a link to the license is provided and it is indicated if changes were made. Users are required to provide full bibliographic description of the original publication (authors, article title, journal title, volume, issue, pages), as well as its DOI code. In electronic publishing, users are also required to link the content with both the original article published in Journal of Medical Biochemistry and the licence used.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.