血清1型前胶原N端前肽：糖尿病足骨髓炎的一种新型诊断试验——一项病例对照研究。

Serum procollagen type 1 N propeptide: A novel diagnostic test for diabetic foot osteomyelitis - A case-control study.

作者信息

Hayes Oliver G, Vangaveti Venkat N, Malabu Usman H

机构信息

Translational Research in Endocrinology and Diabetes (TREAD), College of Medicine and Dentistry, James Cook University, Douglas QLD 4814, Australia.

出版信息

J Res Med Sci. 2018 May 30;23:39. doi: 10.4103/jrms.JRMS_810_16. eCollection 2018.

DOI:10.4103/jrms.JRMS_810_16

PMID:29937901

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5996568/

Abstract

BACKGROUND

The objective of the study was to determine whether serum levels of procollagen type 1 propeptide (P1NP), a bone formation turnover marker, differs between diabetic foot ulcer with osteomyelitis (DFO) and diabetic foot ulcers without osteomyelitis serving as controls. It was also aimed to assess the usefulness of P1NP in diagnosing DFO compared to other common inflammatory markers.

MATERIALS AND METHODS

A case-control study was designed comparing the aforementioned groups. Patients were classified as osteomyelitis and controls based on the International Working Group diagnostic criteria. Serum P1NP and three other inflammatory markers, namely, C-reactive protein (CRP), white blood cells (WBC), and platelets were analyzed on patients with DFO and controls.

RESULTS

The mean serum P1NP levels were significantly higher in the DFO group (: 16), 10.5 ± 5.2 (ng/ml), than the control group (: 11) 3.1 ± 2.8 (ng/ml), = 0.001. P1NP showed the highest sensitivity/specificity 86.7%/80% compared to 70.6%/80%, 56.2%/45.4%, and 50%/37% for CRP, WBC and platelets, respectively. Receiver operator characteristic curves showed the best value of area under the curve of 0.9 for P1NP compared to 0.85, 0.54, and 0.46 for CRP, WBC, and platelets.

CONCLUSION

We found marked elevation of serum P1NP in diabetic foot ulcer with bone infection with potential value in using it to diagnose DFO.

摘要

背景

本研究的目的是确定骨形成转换标志物1型前胶原肽（P1NP）的血清水平在患有骨髓炎的糖尿病足溃疡（DFO）和作为对照的无骨髓炎的糖尿病足溃疡之间是否存在差异。研究还旨在评估与其他常见炎症标志物相比，P1NP在诊断DFO中的效用。

材料与方法

设计了一项病例对照研究来比较上述两组。根据国际工作组诊断标准将患者分为骨髓炎组和对照组。对DFO患者和对照组患者的血清P1NP以及其他三种炎症标志物，即C反应蛋白（CRP）、白细胞（WBC）和血小板进行了分析。

结果

DFO组（n = 16）的平均血清P1NP水平为10.5±5.2（ng/ml），显著高于对照组（n = 11）的3.1±2.8（ng/ml），P = 0.001。与CRP、WBC和血小板的敏感性/特异性分别为70.6%/80%、56.2%/45.4%和50%/37%相比，P1NP显示出最高的敏感性/特异性，为86.7%/80%。受试者工作特征曲线显示，P1NP的曲线下面积最佳值为0.9，而CRP、WBC和血小板的曲线下面积分别为0.85、0.54和0.46。