The Journal of Practical Medicine >
Predictive value of Cys C， HMGB1， GDF-15 levels for early infection after flap reconstruction for diabetic foot ulcer
Received date: 2024-08-27
Online published: 2024-12-16
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 independent 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 （ZCys C?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.
Hongtao FENG , Xiaoping JIAO , Wenxuan SHANG , Hongpu. LI . Predictive value of Cys C， HMGB1， GDF-15 levels for early infection after flap reconstruction for diabetic foot ulcer[J]. The Journal of Practical Medicine, 2024 , 40(23) : 3331 -3336 . DOI: 10.3969/j.issn.1006-5725.2024.23.008
| 1 | KARTIKA R W， ALWI I， SUYATNA F D， et al. The role of VEGF， PDGF and IL-6 on diabetic foot ulcer after Platelet Rich Fibrin， hyaluronic therapy［J］. Heliyon， 2021， 7（9）：e07934. doi:10.1016/j.heliyon.2021.e07934 |
| 2 | 中国微循环学会糖尿病与微循环专业委员会， 中华医学会内分泌学分会基层内分泌代谢病学组， 管庆波， 等. 基层糖尿病微血管疾病筛查与防治专家共识（2024）［J］. 中国全科医学， 2024， 27（32）：3969-3986. |
| 3 | 童利伟， 刘素筠， 侯雨， 等. 糖尿病足溃疡合并铜绿假单胞菌感染PI3K-Akt-mTOR信号通路表达与预后［J］. 中华医院感染学杂志， 2022， 32（17）：2606-2610. |
| 4 | 莫小金， 常树森， 魏在荣， 等. 显微削薄胸背动脉穿支皮瓣修复糖尿病足溃疡的临床应用［J］. 中国修复重建外科杂志， 2022， 36（10）：1266-1272. |
| 5 | 盛玉， 杨秋娜， 王强， 等. NLRP3炎性小体及炎症因子水平预测糖尿病足溃疡皮瓣修复后的早期感染［J］. 中国组织工程研究， 2024， 28（23）：3615-3620. |
| 6 | WANG N， LU Z， ZHANG W， et al. Serum cystatin c trajectory is a marker associated with diabetic kidney disease［J］. Front Endocrinol （Lausanne）， 2022， 13：824279. doi:10.3389/fendo.2022.824279 |
| 7 | 王爱红， 薛婧， 许樟荣. 糖尿病足临床治疗进展与展望［J］. 中华糖尿病杂志， 2022， 14（7）：643-649. |
| 8 | 青梅， 包玉华， 海军， 等. GDF-15及IL-1β基因多态性与糖尿病肾病患者并发导管感染的关联［J］. 中华医院感染学杂志， 2022， 32（16）：2448-2452. |
| 9 | SENDUR S N， FIRLATAN B， BAYKAL G， et al. Serum growth differentiation factor-15 levels are associated with the severity of diabetic foot ulcer［J］. Hormones （Athens）， 2022， 21（4）：719-728. doi:10.1007/s42000-022-00408-4 |
| 10 | 中华人民共和国卫生部. 医院感染诊断标准（试行）［J］. 新医学， 2005， 36（8）：1. |
| 11 | 谷涌泉. 中国糖尿病足诊治指南［J］. 中国临床医生杂志， 2020， 48（1）：19-27. |
| 12 | JIANG P， LI Q， LUO Y， et al. Current status and progress in research on dressing management for diabetic foot ulcer［J］. Front Endocrinol （Lausanne）， 2023， 14：1221705. doi:10.3389/fendo.2023.1221705 |
| 13 | 窦雪娇， 王海英， 陈伟， 等. 多巴酚丁胺对糖尿病足创面游离皮瓣修复术中血流灌注影响的前瞻性研究［J］. 中华烧伤与创面修复杂志， 2023， 39（8）：746-752. |
| 14 | 谢玉国， 范智凌， 郭全保， 等. 踝部软组织缺损患者带蒂逆行小腿后侧肌皮瓣修复的疗效及对感觉功能的影响［J］. 实用医学杂志， 2023， 39（21）：2817-2821. |
| 15 | 黎珊珊， 李珍， 谢桃梅， 等. 糖尿病足溃疡患者血清Hsa＿circ＿0080425表达水平与疾病严重程度及预后的关系研究［J］. 现代检验医学杂志， 2023， 38（4）：59-62， 82. |
| 16 | JIN H. Increased levels of glycosylated hemoglobin， microalbuminuria and serum cystatin C predict adverse outcomes in high-risk pregnancies with gestational diabetes mellitus［J］. Exp Ther Med， 2020， 19（2）：1281-1287. |
| 17 | PANDEY V K， MANI， MAZUMDAR P， et al. Study of Serum Cystatin C and Serum Creatinine in Different Stages of Chronic Kidney Disease Patients［J］. J Assoc Physicians India， 2022， 70（4）：11-12. |
| 18 | 索艳， 谷优优， 刘冬梅， 等. 糖尿病足感染血清IFN-γ、Cys-C、FIB水平与感染严重程度和预后的关系［J］. 中华医院感染学杂志， 2022， 32（17）：2611-2614. |
| 19 | AN J， YU H， GAO Z， et al. Value of cystatin C in predicting recurrence in patients with severe diabetic foot and diabetic foot ulcer［J］. Biomark Med， 2023， 17（5）：287-296. doi:10.2217/bmm-2022-0837 |
| 20 | BEHL T， SHARMA E， SEHGAL A， et al. Expatiating the molecular approaches of HMGB1 in diabetes mellitus： Highlighting signalling pathways via RAGE and TLRs［J］. Mol Biol Rep， 2021， 48（2）：1869-1881. doi:10.1007/s11033-020-06130-x |
| 21 | 谢瑞敏， 李想， 李强强， 等. HMGB1对大鼠糖尿病足溃疡炎症的影响及机制分析［J］. 现代生物医学进展， 2020， 20（13）：2430-2434， 2429. |
| 22 | LINHARES N D， PEREIRA D A， CONCEI??O I M， et al. Noncoding SNPs associated with increased GDF15 levels located in a metformin-activated enhancer region upstream of GDF15［J］. Pharmacogenomics， 2020， 21（8）：509-520. doi:10.2217/pgs-2020-0010 |
| 23 | ZHU X， ZHANG Y， LIANG F， et al. Relationship between plasma growth differentiation factor 15 levels and complications of type 2 diabetes mellitus： A cross-sectional study［J］. Diabetes， 2023， 47（2）：117-123. doi:10.1016/j.jcjd.2022.09.116 |
/
| 〈 |
|
〉 |