The prognostic and diagnostic significance of inflammatory markers TNF-α, IL-6, and IFN-γ in evaluating disease severity in diabetic foot infection.

OBJECTIVE

To investigate the relationship between TNF-α, IL-6, and IFN-γ serum levels and the severity of infection and prognosis in patients with diabetic foot infection (DFI).

METHODS

A total of 144 patients diagnosed with diabetic foot at our hospital from January 2020 to December 2023 were enrolled in the study. Patients were divided into an infection group (70 cases) and a non-infection group (74 cases) based on the presence of infection. The infection group was further categorized into mild (29 cases), moderate (18 cases), and severe infection (23 cases) subgroups according to infection severity. Serum levels of TNF-α, IL-6, and IFN-γ in DFI patients were analyzed, and their predictive value for treatment outcomes was evaluated.

RESULTS

Serum levels of TNF-α, IL-6, and IFN-γ were significantly higher in the infection group than in the non-infection group (P<0.05). Moreover, there were significant differences in TNF-α, IL-6, and IFN-γ levels among patients with mild, moderate, and severe infections (P<0.05). ROC curve analysis demonstrated that the area under the curve (AUC) for the combined detection of TNF-α, IL-6, and IFN-γ in assessing DFI severity was 0.855, which was significantly higher than that of TNF-α (0.811), IL-6 (0.793), and IFN-γ (0.764) (P<0.05). Furthermore, serum levels of TNF-α, IL-6, and IFN-γ were significantly higher in the poor prognosis group than in the good prognosis group (P<0.05). ROC curve analysis showed that the AUC for predicting poor prognosis in DFI patients was 0.926 when TNF-α, IL-6, and IFN-γ were combined, which was significantly higher than that of TNF-α (0.849), IL-6 (0.834), and IFN-γ (0.809) (P<0.05).

CONCLUSION

Serum levels of TNF-α, IL-6, and IFN-γ are elevated in DFI patients and are closely associated with infection severity and prognosis. The combined detection of these three inflammatory factors can serve as a predictive indicator for infection severity and poor prognosis in DFI patients.