Study on the correlation between SINBAD system score and wound pH value in diabetic foot sarcopenia

Abstract

Objective

To investigate the diagnostic value of the SINBAD system score combined with wound pH value in diabetic foot sarcopenia.

Methods

This is a cross-sectional observational clinical study. From June 2023 to June 2024, diabetic foot patients attending the outpatient clinic of Shanghai Yangpu hospital were consecutively enrolled. Data collected included skeletal muscle index, grip strength, 6-m walking speed, SINBAD system classification, and wound pH value. Based on the diagnostic criteria of the European Working Group on Sarcopenia, patients were classified into three groups: Non-sarcopenia group, pre-sarcopenia group, and sarcopenia group. Between-group comparisons were made using one-way ANOVA, Kruskal-Wallis H test, or Chi-square test. Spearman's correlation analysis was used to assess the correlation between the SINBAD system score and sarcopenia-related indicators. Pearson's correlation analysis was employed to evaluate the correlation between wound pH and sarcopenia-related indicators. Binary logistic regression was performed to analyze the factors influencing sarcopenia in diabetic foot patients. The diagnostic value of the SINBAD system score combined with wound pH value in diabetic foot sarcopenia was assessed using receiver operating characteristic (ROC) curves.

Results

A total of 71 diabetic foot patients were enrolled. Of these, 29 were in the Non-sarcopenia group, 13 in the pre-sarcopenia group, and 29 in the sarcopenia group. Compared with the Non-sarcopenia group and pre-sarcopenia group, the sarcopenia group had significantly longer diabetes duration and diabetic foot disease duration (P < 0.05). The sarcopenia group had lower grip strength compared to both the Non-sarcopenia group and pre-sarcopenia group (P < 0.05). The skeletal muscle index (SMI) of the sarcopenia group was significantly lower than that of the Non-sarcopenia group and pre-sarcopenia group (P < 0.05). Pearson correlation analysis showed that wound pH value was negatively correlated with SMI (r = −0.476, P < 0.001) and grip strength (r = −0.478, P < 0.05). Spearman correlation analysis revealed that the SINBAD system score was negatively correlated with SMI (r = −0.716, P < 0.05) and grip strength (r = −0.666, P < 0.05). Binary logistic regression analysis indicated that an increased wound pH value (OR = 29.126, 95 % CI 1.234–687.583) and higher SINBAD system score (OR = 5.271, 95 % CI 2.144–12.961) were significant factors influencing the presence of sarcopenia in diabetic foot patients. ROC curve analysis showed that the combination of wound pH value and SINBAD system score had a high diagnostic value for sarcopenia in diabetic foot patients, with an area under the curve (AUC) of 0.933.

Conclusion

The wound pH value and SINBAD system score are associated with the occurrence of sarcopenia in diabetic foot patients and have diagnostic value for sarcopenia in this population.