Lipid profile and inflammatory biomarkers as a prognostic factor for outcome in DFUs: Is there any relationship?

 A diabetic foot ulcer (DFUs) is a major health problem, which concerns 15% patients with diabetes worldwide. Amputation is a feared complication of diabetes. Few studies have identified factors as predictors of clinical prognosis of patients with DFUs, especially of Iranian patients. In this study, we assessed the prognostic factors of Iranian patients with DFUs.

Prospective cohort hospital based study conducted in Patients with diabetic foot ulcer from June 2015 - June 2016. Diagnosis of diabetic foot ulcer was based on WAGNER – MEGGIT criteria and patients with grade 2 and more were evaluated. Patients were followed up for three months in order to determine the desired outcome (recovery or amputation). Data collection was done by checklist design and lipid profile (Triglyceride, Cholesterol, HDL-C, LDL-C) and inflammatory biomarker (ESR and CRP levels) were entered to the checklist. All statistical calculations and analyses were performed by using SPSS software (version 16). P value of less than 0.05 was considered significant.

In total, the study included 72 patients with DFUs and 58.3% of the patients were man. Mean age of the patients was 59.19+/- 11.94 years and mean duration of diabetes was 15.52+/- 8.62. The majority of patients (94.8%, 68 cases) had type 2 diabetes mellitus. 70.8% had ESR>= 50, 35.9% had CRP>= 3+, 95.6% had HbA1C >=7, 58.6% had LDL>100, 95.5% had HDL<50 and 67.2% had TG<200. Follow up time was 3 months from hospital discharge. The overall limb amputation rate in the current study was 21.3%.

Our results demonstrated that limb amputation rate is not correlated with sex, ESR, HbA1c, WBC, LDL, HDL. Significant univariate predictive factors for limb amputation was CRP level and Triglyceride level. (p= 0.91 and p= 0.064 respectively)