Evidence map›Paper›PMID 41057595›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026

Wasting phenotype for differentiating spinal tuberculosis from spinal pyogenic infection.

Zijun Wu, Fangxu Jia, Yiyan Chen, Yunran Wang, Haoling He, Ruixin Feng, Ziyang Zhu, Qile Gao, Xiaoping Yi, Bihong T Chen

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Spinal infections.Frontiers in neuroscience · 2026
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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Zijun WuXiangya School of Public Health, Central South University, 410083, Changsha, China.
Fangxu JiaXiangya School of Public Health, Central South University, 410083, Changsha, China.
Yiyan ChenCentral South University, Changsha, China.
Yunran WangXiangya School of Public Health, Central South University, 410083, Changsha, China.
Haoling HeFirst Affiliated Hospital of Guangxi Medical University, 530021, Nanning, China.
Ruixin FengCentral South University, Changsha, China.
Ziyang ZhuCentral South University, Changsha, China.
Qile GaoCentral South University, Changsha, China. gaoql@csu.edu.cn.
Xiaoping YiDepartment of Radiology, Chongqing University Three Gorges Hospital, Chongqing University, Chongqing, China. yixiaoping@csu.edu.cn.
Bihong T ChenCity of Hope National Medical Center, Duarte, United States.

Funding

National Natural Science Foundation of China 82472469
6 · The paper itself

Abstract

backgroundSpinal tuberculosis (STB) and pyogenic spinal infection (PSI) often present with overlapping clinical manifestations and imaging features, leading to delayed diagnosis and suboptimal outcomes. Identifying reliable laboratory-based markers may improve early differential diagnosis. PURPOSES: To investigate wasting phenotype-related clinical and laboratory indicators for differentiating STB from PSI and to establish a clinically applicable diagnostic model.

methodsIn this prospective study, 253 patients with confirmed spinal infections were enrolled, including 159 with STB (62.85%) and 94 with PSI (37.15%). Demographic, clinical, and routine laboratory data were collected. Eight candidate metabolic and inflammatory variables were assessed using univariate analyses and multivariable logistic regression. Model performance was evaluated by receiver operating characteristic (ROC) analysis, calibration testing, and Youden-derived optimal thresholds.

resultsThree key variables-body temperature, high-density lipoprotein (HDL), and blood glucose-were independently associated with STB. In the adjusted model, each 1 °C increase in temperature reduced the odds of STB by approximately 69% (OR = 0.318; 95% CI: 0.138-0.731; P = 0.009), each 1 mmol/L increase in HDL increased the odds by 3.7-fold (OR = 3.692; 95% CI: 1.311-10.394; P = 0.011), and each 1 mmol/L increase in blood glucose reduced the odds by 24% (OR = 0.764; 95% CI: 0.622-0.938; P = 0.014). The model demonstrated moderate discrimination (AUC = 0.673, 95% CI: 0.604-0.740) but good calibration (P = 0.609). ROC-derived optimal thresholds were T ≤ 36.7 °C, HDL ≥ 0.89 mmol/L, and blood glucose ≤ 5.85 mmol/L, providing practical reference points for clinical application.

conclusionA composite wasting phenotype defined by lower body temperature, lower blood glucose, and elevated HDL significantly improves early differentiation of STB from PSI. While individual thresholds show limited standalone diagnostic value, the combined model provides a biologically plausible, interpretable, and clinically useful tool to aid decision-making in managing spinal infections. LEVELS OF EVIDENCE: Level 3 (According to the Oxford CEBM 2016 criteria for diagnostic studies).

Indexed as

Tuberculosis, SpinalAdultAgedBlood GlucoseBody TemperatureDiagnosis, DifferentialFemaleHumansMaleMiddle AgedPhenotypeProspective StudiesBlood GlucoseDiagnostic modelLogistic regressionPyogenic spinal infectionSpinal tuberculosisWasting phenotype

Identifiers

PMID41057595

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.