Predictive value of Cys C,HMGB1,GDF-15 levels for early infection after flap reconstruction for diabetic foot ulcer
10.3969/j.issn.1006-5725.2024.23.008
- VernacularTitle:胱抑素C、高迁移率族蛋白1和生长分化因子-15水平对糖尿病足溃疡皮瓣修复术后早期感染的预测价值
- Author:
Hongtao FENG
1
;
Xiaoping JIAO
1
;
Wenxuan SHANG
1
;
Hongpu LI
1
Author Information
1. 河南中医药大学人民医院(郑州人民医院)血管外科(河南郑州 450000)
- Publication Type:Journal Article
- Keywords:
diabetic foot ulcer;
flap repair;
cystatin C;
high mobility group box 1;
growth differ-entiation factor-15
- From:
The Journal of Practical Medicine
2024;40(23):3331-3336
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the predictive value of cystatin C(Cys C),high mobility group box 1(HMGB1),and growth differentiation factor-15(GDF-15)levels for early infection after flap reconstruction for diabetic foot ulcer(DFU).Methods From July 2021 to March 2024,155 DFU patients treated in our hospital were included in DFU group.DFU patients were assigned into non-infection group(104 cases)and infection group(51 cases)according to whether there was infection at the operation site within one week after flap reconstruction.Control group included 85 patients with diabetes but without foot ulcer.Latex immunoturbidimetry was applied to detect serum Cys C level;enzyme linked immunosorbent assay to detect serum levels of HMGB1 and GDF-15;multivariate logistic regression to analyze the factors affecting early infection after flap reconstructionfor DFU,and receiver operating characteristic(ROC)curve to analyze the predictive value of serum Cys C,HMGB1,and GDF-15 levels for early infection after flap reconstruction for DFU.Results The expression levels of serum Cys C,HMGB1,and GDF-15 were obviously higher in the DFU group(P＜0.05)when compared with those in the control group.The expression levels of FPG,CRP,Cys C,HMGB1,and GDF-15 were obviously higher in the infection group(P＜0.05)when compared with those in the non-infection group.Cys C,HMGB1,GDF-15,FPG,and CRP were all inde-pendent risk factors for early infection after flap reconstruction for DFU(P＜0.05).The AUC predicted by serum Cys C,HMGB1,and GDF-15 alone for early infection after flap reconstruction for DFU was 0.810,0.850,and 0.828,respectively.The AUC predicted by the combination of these three markers was 0.930,which was better than that predicted by the three markers alone(ZCysC-three combination=3.381,ZHMGB1-three combination=2.588,ZGDF-15-three combination=2.857,all P＜0.05).Conclusions Cys C,HMGB1,and GDF-15 are upregulated in the serum of DFU patients,and all the three are factors affecting early infection after flap reconstruction for DFU.The combination of the three has high predictive value for early infection after DFU flap repair.
