系统免疫炎症指数与糖尿病足溃疡患者截肢的关系。
Relationship between systemic immune inflammation index and amputation in patients with diabetic foot ulcer.
机构信息
Cardioavascular Surgery Department, Harran University Faculty of Medicine, Sanliurfa, Turkey.
Endokrinology Department, Harran University Faculty of Medicine, Sanliurfa, Turkey.
出版信息
J Orthop Sci. 2024 Jul;29(4):1060-1063. doi: 10.1016/j.jos.2023.07.015. Epub 2023 Jul 31.
AIM
The systemic immune inflammation index (SII) is a cost-effective biomarker calculated by lymphocyte, neutrophil and platelet counts and is currently being studied in various diseases. Since there is no study examining the relationship between SII and diabetic foot ulcers (DFU) in the literature, our aim was to investigate the relationship between SII and amputation rate in DFU.
METHODS
Type 2 DM 511 patients with DFU were screened from 2017 to 2021. Laboratory data obtained on the first day of hospitalization were considered. Platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and SII were calculated from routine blood count. Participants were divided into two groups as amputation (Group 1) and non-amputation (Group 2).
RESULTS
Amputation rate was 18.8%. The A1c (8.80 (3.26) % vs. 9.52 (3.10) %, p = 0.007) and HGB (10.17 ± 2.16 g/dL vs. 12.05 ± 2.20 g/dL, p < 0.001) levels, and lymphocyte count (1.81 (1.16) vs. 2.05 (1.11), p = 0.015) were significantly lower in Group 1 than Group 2. The counts of WBC (14.01 (9.16) × 10/L vs. 10.41 (5.82) × 10/L), PLT (393.35 (196.98) × 10/L vs. 312.05 (141.33) × 10/L), neutrophil (11.52 (8.75) × 10/L vs. 6.93 (5.96) × 10/L), PLR (226.04 (159.24) × 10/L vs. 153.12 (101.91) × 10/L), NLR (6.64 (6.93) vs. 3.34 (3.99)) and SII (2505.86 (3957.47) × 10/L vs. 1092.50 (1476.08) × 10/L), and the levels of CRP (14.12 (12.66) mg/dL vs. 3.86 (12.63) mg/dL) and ESR (87.50 (50.50) mm/h vs. 63.00 (57.25) mm/h) were significantly higher in Group 1 than Group 2 (all p < 0.001). AUC of ROC analysis of PLR was 0.666 (95% CI, 0.604-0.728), NLR was 0.695 (95% CI, 0.638-0.752) and SII was 0.716 (95% CI, 0.661-0.772) for the predicting of amputation and the SII had the best AUC with 67.4% sensitivity and 63.3%specificty.
CONCLUSION
SII is a cost-effective and readily available marker, but alone may not be sufficient to predict the risk of amputation in DFU. In our results, the predictive role of SII alone or with other markers for future DFU and its role in predicting other chronic diabetic complications will be evaluated in extensive studies.
目的
全身性免疫炎症指数（SII）是一种通过计算淋巴细胞、中性粒细胞和血小板计数得出的具有成本效益的生物标志物，目前正在各种疾病中进行研究。由于文献中没有研究检查 SII 与糖尿病足溃疡（DFU）之间的关系，我们的目的是研究 SII 与 DFU 截肢率之间的关系。
方法
从 2017 年至 2021 年筛选出 511 例患有 DFU 的 2 型糖尿病患者。考虑入院第一天获得的实验室数据。从常规血象中计算血小板与淋巴细胞比值（PLR）、中性粒细胞与淋巴细胞比值（NLR）和 SII。将参与者分为截肢组（第 1 组）和非截肢组（第 2 组）。
结果
截肢率为 18.8%。第 1 组的 A1c（8.80（3.26）%比 9.52（3.10）%，p=0.007）和 HGB（10.17±2.16 g/dL 比 12.05±2.20 g/dL，p<0.001）水平以及淋巴细胞计数（1.81（1.16）比 2.05（1.11），p=0.015）明显低于第 2 组。白细胞计数（14.01（9.16）×10/L 比 10.41（5.82）×10/L）、血小板计数（393.35（196.98）×10/L 比 312.05（141.33）×10/L）、中性粒细胞计数（11.52（8.75）×10/L 比 6.93（5.96）×10/L）、PLR（226.04（159.24）×10/L 比 153.12（101.91）×10/L）、NLR（6.64（6.93）比 3.34（3.99））和 SII（2505.86（3957.47）×10/L 比 1092.50（1476.08）×10/L）以及 CRP（14.12（12.66）mg/dL 比 3.86（12.63）mg/dL）和 ESR（87.50（50.50）mm/h 比 63.00（57.25）mm/h）的水平明显高于第 1 组（均 p<0.001）。PLR 的 ROC 分析 AUC 为 0.666（95%CI，0.604-0.728），NLR 为 0.695（95%CI，0.638-0.752），SII 为 0.716（95%CI，0.661-0.772），可预测截肢，SII 的 AUC 最佳，灵敏度为 67.4%，特异性为 63.3%。
结论
SII 是一种具有成本效益且易于获得的标志物，但单独使用可能不足以预测 DFU 截肢的风险。在我们的结果中，将在广泛的研究中评估 SII 单独或与其他标志物对未来 DFU 的预测作用及其对预测其他慢性糖尿病并发症的作用。
Zotero 插件