Al-Shammaree Shatha Abdul Wadood, Abu-ALkaseem Banan Akram, Salman Isam N
Department of Chemistry, College of Science, University of Baghdad, Baghdad, Iraq.
National Center of Diabetes, College of Medicine, Al-Mustansiriya University, Baghdad, Iraq.
J Res Med Sci. 2017 Aug 16;22:95. doi: 10.4103/jrms.JRMS_906_16. eCollection 2017.
Diagnosis of infection in diabetic foot ulcer (DFU) is not always simple. The analytic precision of procalcitonin (PCT) was evaluated to clarify the use of PCT for distinguish the presence of infection in DFU in comparison to other inflammatory markers.
This study comprised 88 subjects distributed into four groups: 16 nondiabetic healthy subjects (group control), 17 patients with type 2 diabetes mellitus without foot Complication (group DM), 25 patients with noninfected diabetic foot (group NIDF), and 30 patients with infected diabetic foot (group IDF). Fasting blood samples were taken for measurement of glucose, hemoglobin A1C, lipid profile, renal function, erythrocyte sedimentation rate (ESR), and white blood cell (WBC) and its derivatives. Plasma PCT was determined using an enzyme-linked immunosorbent assay.
PCT, WBC, ESR, and neutrophils (NEU) were found significantly higher in IDF group than other groups. The receiver operating characteristic analysis showed that sensitivity, specificity, the best cutoff value, and the area under the curve were for ESR (100%, 93%, 31.5 mm/h, 1; < 0.001), for PCT (87.5%, 86.7%, 66.55 pg/dl, 0.977; < 0.001), for NEU (93.8%, 93.3%, 5.35, 0.957; < 0.001) and for WBC (93.8%, 90%, 9.29 × 10/L, 0.942; < 0.001), respectively.
The outcomes of this study recommend that PCT can be an asymptomatic marker in the diagnosis of infection in DFU with higher Wagner grades in combination with different inflammatory markers.
糖尿病足溃疡（DFU）感染的诊断并非总是简单易行。评估降钙素原（PCT）的分析精度，以阐明与其他炎症标志物相比，PCT在区分DFU感染存在方面的应用。
本研究包括88名受试者，分为四组：16名非糖尿病健康受试者（对照组）、17名无足部并发症的2型糖尿病患者（DM组）、25名非感染性糖尿病足患者（NIDF组）和30名感染性糖尿病足患者（IDF组）。采集空腹血样以测量血糖、糖化血红蛋白、血脂、肾功能、红细胞沉降率（ESR）、白细胞（WBC）及其衍生物。使用酶联免疫吸附测定法测定血浆PCT。
发现IDF组的PCT、WBC、ESR和中性粒细胞（NEU）显著高于其他组。受试者工作特征分析表明，ESR的敏感性、特异性、最佳截断值和曲线下面积分别为（100%，93%，31.5mm/h，1；<0.001），PCT为（87.5%，86.7%，66.55pg/dl，0.977；<0.001），NEU为（93.8%，93.3%，5.35，0.957；<0.001），WBC为（93.8%，90%，9.29×10/L，0.942；<0.001）。
本研究结果表明，PCT可作为DFU感染诊断中的一个无症状标志物，与不同炎症标志物联合用于诊断Wagner分级较高的DFU感染。
