Nie Xin, Gao Lei, Wang Lei, Wang Jiangning
Department of Orthopedic Surgery, Beijing Shijitan Hospital, Capital Medical University, Haidian District, Beijing, P.R. China.
Surg Infect (Larchmt). 2020 Feb;21(1):9-14. doi: 10.1089/sur.2019.020. Epub 2019 Aug 1.
Osteomyelitis of the diabetic foot is a costly health problem worldwide. Early and accurate diagnosis of the disease in patients with diabetic foot infections is needed urgently and will have an important role in diabetic foot management. This was a case-control study of subjects with diabetic foot ulcers admitted to Beijing Hospital from September 2015 to April 2018. We compared differences in the atherogenic index of plasma (AIP) in patients with or without osteomyelitis. The mean AIP of 165 patients with osteomyelitis was 0.23 ± 0.24, which was significantly higher than the mean AIP of patients without osteomyelitis. Higher AIP values were associated with a considerably higher risk of osteomyelitis with an odds ratio of 1.81 (95% confidence interval [CI] 0.71-4.61), 4.70 (1.88-11.75), 5.03 (2.06-12.25) and 1.74 (1.33-2.28). Moreover, at a cut-off of 0.184, the AIP value showed a sensitivity of 84.3% and a specificity of 83.1% in the discriminatory identification of diabetic foot osteomyelitis. Elevated AIP was significantly associated with diabetic foot osteomyelitis, supporting the use of this index as a biomarker for the diagnosis in clinical practice.
糖尿病足骨髓炎是一个在全球范围内代价高昂的健康问题。糖尿病足感染患者急需对该病进行早期准确诊断,这在糖尿病足的管理中将发挥重要作用。这是一项对2015年9月至2018年4月在北京医院住院的糖尿病足溃疡患者进行的病例对照研究。我们比较了有或无骨髓炎患者的血浆致动脉粥样硬化指数(AIP)的差异。165例骨髓炎患者的平均AIP为0.23±0.24,显著高于无骨髓炎患者的平均AIP。较高的AIP值与骨髓炎风险显著升高相关,优势比分别为1.81(95%置信区间[CI]0.71 - 4.61)、4.70(1.88 - 11.75)、5.03(2.06 - 12.25)和1.74(1.33 - 2.28)。此外,在截断值为0.184时,AIP值在鉴别诊断糖尿病足骨髓炎时的敏感性为84.3%,特异性为83.1%。AIP升高与糖尿病足骨髓炎显著相关,支持将该指标用作临床实践中诊断的生物标志物。