The potential impact and diagnostic value of inflammatory markers on diabetic foot progression in type II diabetes mellitus: A case–control study; [Impacto potencial y valor pronóstico de los marcadores inflamatorios en la progresión del pie diabético en diabetes mellitus tipo II. Un estudio de casos y controles]

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Mohamed A.A.; Elmotaleb Hussein M.A.; Nabil Hanna I.; Japer Nashwan A.J.; Saleh M.; Abdel Wahed W.Y.; Mohamed Mansour A.M.; Ezz Al Arab M.R.; Fawzy N.; Sakr Y.; Shalby H.; AlHussain E.; Kamal Darwish M.; El-Osaily H.; Naguib M.; Mohamed A.A.; Farouk Mohamed W.; Hafez W.

Journal: Medicina Clinica

Publisher: Ediciones Doyma, S.L.

Publication Date: May 2024

Volume / Issue: Volume 162 / Issue 9

Pages: e33–e39

ISSN: 257753

DOI: 10.1016/j.medcli.2024.01.009

Scopus: View on Scopus

PubMed: 38458959

Document Type: Article

Access: All Open Access; Green Open Access; Hybrid Gold Open Access

Authors and Affiliations

Mohamed A.A., Biochemistry Department, National Hepatology and Tropical Medicine Research Institute, Gothi, Egypt; Elmotaleb Hussein M.A., Internal Medicine Department, National Institute of Diabetes and Endocrinology, Egypt; Nabil Hanna I., Surgical Department, National Institute of Diabetes and Endocrinology, Egypt; Japer Nashwan A.J., Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar; Saleh M., Gastroentrology Department, National Hepatology and Tropical Medicine Research Institute, Egypt; Abdel Wahed W.Y., Public Health and Community Medicine, Faculty of Medicine, Fayoum University, Egypt; Mohamed Mansour A.M., Biochemistry Department, Faculty of Science, Fayoum University, Egypt; Ezz Al Arab M.R., Hepatology and Gastroenterology Department, Ahmed Maher Teaching Hospital, Egypt; Fawzy N., Clinical and Chemical Pathology Department, National Institute of Diabetes and Endocrinology, Egypt; Sakr Y., Clinical and Chemical Pathology Department, National Institute of Diabetes and Endocrinology, Egypt; Shalby H., Internal Medicine Department, Faculty of Medicine, Misr University for Science and Technology, Egypt; AlHussain E., Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Egypt; Kamal Darwish M., Chemistry Department (Biochemistry Branch), Faculty of Science, Suez University, Suez, 43518, Egypt; El-Osaily H., Biochemistry Department, Faculty of Pharmacy, Ahram Canadian University, Egypt; Naguib M., Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt; Mohamed A.A., Intensive Care Unit, Theodor Bilharz Research Institute, Giza, Egypt; Farouk Mohamed W., Healthpoint Hospital, Abu Dhabi, United Arab Emirates; Hafez W., Internal Medicine Department, National Research Centre, Elbohoos Street, Dokki, Giza, Egypt

Abstract

Background: The wound-healing process in diabetic foot is affected by pro and anti-inflammatory markers, and any disruption in the inflammatory reaction interferes with tissue homeostasis, leading to chronic non-wound healing. Aim: This study aimed to determine the diagnostic value and effect of CRP, IL-6, TNF, and HbA1c on initiation the and progression of diabetic foot ulcers. Method: ELISA was used to quantify IL-6, TNF, CRP, and HbA1c in 205 patients with diabetes, and 105 were diabetic foot free. The prevalence and progression of diabetic foot were also evaluated. The area under the curve (AUC) was calculated using the receiver operating characteristic (ROC) curve to analyze the predictive values. Forward stepwise logistic regression analysis was used to compute the odds ratio (OR) and the corresponding 95% confidence intervals (CIs). Results: CRP, IL-6, and FBS were found to be significant predictors of diabetic foot (OR = 1.717, 95% CI = 1.250–2.358, P = 0.001; OR = 1.434, 95% CI = 1.142–1.802, P = 0.002; and OR = 1.040, 95% CI = 1.002–1.080, P = 0.037), respectively. The AUCs for CRP, IL-6, and HbA1c in predicting diabetic foot were 0.839, 0.728, and 0.834, respectively, demonstrating a good predictive value for each diagnostic marker. Conclusion: The current study demonstrated that IL-6, CRP, and HbA1c may be useful biomarkers to indicate diabetic foot progression. Furthermore, our findings showed a substantial relationship between CRP and HbA1c in individuals with diabetic foot conditions. © 2024 The Author(s)

Keywords

CRP; Diabetes; Foot ulcer; HbA1c; IL-6; Inflammatory cytokine; TNF; Aged; Biomarkers; C-Reactive Protein; Case-Control Studies; Diabetes Mellitus, Type 2; Diabetic Foot; Disease Progression; Female; Glycated Hemoglobin; Humans; Interleukin-6; Logistic Models; Male; Middle Aged; Predictive Value of Tests; ROC Curve; Tumor Necrosis Factor-alpha; biological marker; C reactive protein; cholesterol; creatinine; hemoglobin A1c; interleukin 6; triacylglycerol; tumor necrosis factor; urea; hemoglobin A1c protein, human; adult; Article; case control study; cohort analysis; controlled study; diabetic foot ulcer; diagnostic test accuracy study; diagnostic value; disease exacerbation; disease severity; enzyme linked immunosorbent assay; human; leukocyte count; logistic regression analysis; major clinical study; non insulin dependent diabetes mellitus; predictive value; prevalence; receiver operating characteristic; sensitivity and specificity; blood; complication; statistical model

Citation Information

Scopus Citations: 19

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