Correlation between serum adenosine deaminase levels and risk of diabetic foot ulcers in patients with type 2 diabetes mellitus.

OBJECTIVES

Adenosine deaminase (ADA) is a critical enzyme in the catabolism of adenosine acid during purine metabolism and plays a significant role in the diagnosis and monitoring of various diseases. This study aims to investigate the relationship between serum ADA levels and risk of diabetic foot ulcers (DFU) in patients with type 2 diabetes mellitus (T2DM), providing a clinical basis for the prevention and treatment of DFU.

METHODS

A retrospective study was conducted on 2 719 T2DM patients diagnosed at the Southwest Hospital of Army Medical University from January 2019 to January 2020. Patients were divided into a non-DFU group (=1 952) and a DFU group (=767) based on the presence of DFU. Serum ADA levels were collected, and participants were divided into quartiles: Q1, Q2, Q3, and Q4. Spearman correlation analysis and multivariate logistic regression were used to assess the relationship between serum ADA levels and DFU risk in T2DM patients. Additionally, changes in serum ADA levels among DFU patients with different Wagner grades were compared.

RESULTS

The prevalence of DFU in T2DM patients was 28.21%, and the prevalence increased with higher serum ADA levels. Multivariate-adjusted logistic regression analysis showed that for every 1-unit increase in serum ADA, the risk of DFU increased by 3% (=1.03, 95% 1.01 to 1.05, =0.003). Compared with the Q1 group, the risk of DFU increased in the Q2 (=1.77, 95% 1.30 to 2.43, <0.001), Q3 (=2.11, 95% 1.54 to 2.89, <0.001), and Q4 (=2.27, 95% 1.64 to 3.16, <0.001) groups. Additionally, serum ADA levels increased with higher Wagner grades from 0 to 5 (<0.001).

CONCLUSIONS

Elevated serum ADA levels in T2DM patients are associated with an increased risk of DFU, suggesting that serum ADA may play an important role in the development of DFU in T2DM patients.