Neutrophil-lymphocyte ratio (NLR); an accurate inflammatory marker to predict diabetic foot ulcer amputation: a matched case-control study.

IF 2.8 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

BMC Endocrine Disorders Pub Date : 2025-04-27 DOI:10.1186/s12902-025-01941-0

Faeze Afshar, Morteza Daraie, Fatemeh Mohammadi, Kiana Seifouri, Samira Amin Afshari, Soheil Heidari Some'eh, Amirhossein Yadegar, Parnian Naghavi, Alireza Esteghamati, Soghra Rabizadeh, Mahsa Abbaszadeh, Manouchehr Nakhjavani, Sahar Karimpour Reyhan

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Abstract

Background: Diabetic foot ulcer (DFU) is a well-known complication of diabetes. The main therapeutic options for treating DFU include surgical debridement. However, conditions such as sensory loss and insufficient blood supply can lead to lower extremity amputations. Inflammatory biomarkers, including the neutrophil‒lymphocyte ratio (NLR) and platelet‒lymphocyte ratio (PLR), have shown promise in predicting the development of diabetes complications.

Methods: This study included 126 individuals with known DFUs who underwent amputation or debridement surgery during hospitalization between January 2017 and December 2022. The participants were divided into two groups, each containing 63 patients, based on the treatment they received. Analyses were conducted via univariate and multivariate regression models. The linearity of the relationship between each inflammatory index and the risk of amputation was further examined via restricted cubic spline (RCS) curves with four knots.

Results: Categorical regression analysis showed an elevated risk of amputation in patients with an NLR greater than 6.08, with an OR of 13.090 (95% CI: 5.143-33.320, P < 0.001), compared with those with an NLR less than 6.08. Additionally, patients with a PLR greater than 210 demonstrated a similarly elevated risk of amputation with an OR of 2.31 (95% CI: 1.066‒4.669, P = 0.033); however, those with lymphocyte‒white blood cell ratio (LWR) levels of greater than 0.1265 exhibited reduced likelihood of having amputation (OR: 0.092 (95% CI: 0.038‒0.226, P < 0.001)).

Conclusions: This study supports that NLR, PLR and LWR may have value as a predictive marker for amputation in patients with DFUs.

查看原文本刊更多论文

中性粒细胞-淋巴细胞比值；预测糖尿病足溃疡截肢的准确炎症标志物：一项匹配的病例对照研究。

背景：糖尿病足溃疡（DFU）是一种众所周知的糖尿病并发症。治疗DFU的主要治疗方法包括手术清创。然而，感觉丧失和血液供应不足等情况可导致下肢截肢。炎症生物标志物，包括中性粒细胞-淋巴细胞比率（NLR）和血小板-淋巴细胞比率（PLR），已经显示出预测糖尿病并发症发展的希望。方法：本研究纳入了2017年1月至2022年12月住院期间接受截肢或清创手术的126例已知DFUs患者。参与者根据接受的治疗分为两组，每组63名患者。通过单因素和多因素回归模型进行分析。通过带有四个节的限制性三次样条（RCS）曲线进一步检查各炎症指数与截肢风险之间的线性关系。结果：分类回归分析显示，NLR大于6.08的患者截肢风险增加，OR为13.090 （95% CI: 5.143-33.320， P）。结论：本研究支持NLR、PLR和LWR可能作为DFUs患者截肢的预测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Endocrine Disorders ENDOCRINOLOGY & METABOLISM-

CiteScore

4.40

自引率

0.00%

发文量

280

审稿时长

>12 weeks

期刊介绍： BMC Endocrine Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of endocrine disorders, as well as related molecular genetics, pathophysiology, and epidemiology.