Zhang Yang, Zhou Shumin, Wang Xianbin, Zhou Haiyan
Department of Plastic Surgery, Foresea Life Insurance Guangzhou General Hospital, Guangzhou, Guangdong Province, China.
Department of Endocrinology, Guangzhou Development District Hospital, Guangzhou, Guangdong Province, China.
PLoS One. 2025 Jun 12;20(6):e0326082. doi: 10.1371/journal.pone.0326082. eCollection 2025.
Diabetic foot is a serious complication of diabetes, and inflammation plays a key role in its pathogenesis. This population-based study investigates associations between complete blood count (CBC)-derived inflammatory markers and diabetic foot, while evaluating metabolic mediators in these relationships.
Data from 1,246 participants across three National Health and Nutrition Examination Survey (NHANES) cycles (1999-2004) were analyzed. Calculated inflammatory markers included monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), neutrophil-monocyte-to-lymphocyte ratio (NMLR), and systemic inflammatory response index (SIRI). Weighted logistic regression models assessed marker-diabetic foot associations, supplemented by subgroup and restricted cubic spline (RCS) analyses for nonlinearity. Mediation analysis quantified metabolic contributions.
CBC-derived inflammatory markers demonstrated significant positive correlations with diabetic foot risk. Risk increased as quartiles for these markers increased. RCS analysis further revealed a significant nonlinear relationship between them. Serum creatinine (12.46%) and albumin (11.33%) mediated significant proportions of these associations.
CBC-derived inflammatory markers serve as accessible predictors of diabetic foot risk, with nonlinear patterns. The partial mediation by metabolic indicators highlights dual inflammatory-metabolic pathways in diabetic foot pathogenesis. Routine CBC-derived inflammatory markers monitoring could enable early risk stratification, while targeting metabolic abnormalities may amplify preventive strategies.
糖尿病足是糖尿病的一种严重并发症，炎症在其发病机制中起关键作用。这项基于人群的研究调查了全血细胞计数（CBC）衍生的炎症标志物与糖尿病足之间的关联，同时评估了这些关系中的代谢介质。
分析了来自三个国家健康与营养检查调查（NHANES）周期（1999 - 2004年）的1246名参与者的数据。计算得出的炎症标志物包括单核细胞与淋巴细胞比值（MLR）、中性粒细胞与淋巴细胞比值（NLR）、中性粒细胞 - 单核细胞与淋巴细胞比值（NMLR）以及全身炎症反应指数（SIRI）。加权逻辑回归模型评估标志物与糖尿病足的关联，并通过亚组分析和限制立方样条（RCS）分析来评估非线性关系。中介分析量化代谢贡献。
CBC衍生的炎症标志物与糖尿病足风险呈显著正相关。随着这些标志物四分位数的增加，风险也增加。RCS分析进一步揭示了它们之间存在显著的非线性关系。血清肌酐（12.46%）和白蛋白（11.33%）介导了这些关联的很大比例。
CBC衍生的炎症标志物可作为糖尿病足风险的可及预测指标，呈现非线性模式。代谢指标的部分中介作用凸显了糖尿病足发病机制中的炎症 - 代谢双重途径。常规监测CBC衍生的炎症标志物可实现早期风险分层，而针对代谢异常可能会增强预防策略。
