ArticleJournal of medical biochemistry2026
Risk correlation analysis of serum adiponectin (APN), D-dimer (DD) and the neutrophil - lymphocyte ratio (NLR) with the prognosis of diabetic foot ulcer infection.
Article in Journal of medical biochemistry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: To investigate the connections between diabetic foot ulcer infection patient prognosis and disease severity, we measured serum adiponectin (APN) and D-dimer (D-D) levels and the neutrophil lymphocyte ratio (NLR). Methods: A total of 292 patients with diabetic foot ulcer infection admitted to our hospital from February 2024 to February 2025 were selected and divided into mild (n = 95), moderate (n = 139) and severe (n = 58) patients according to the severity of the disease. The levels of serum APN and D-D and the NLR in patients with different severity levels were compared. To analyse the serum APN, D-D, and NLR, patients were followed up for one year, and the prognoses of the patients were statistically analysed. Results: Comparisons of the serum APN, D-D and NLR levels among patients with different disease severities revealed that the serum APN levels in patients with moderate disease were lower than those in patients with mild disease (P<0.05). The serum APN of severe patients was 5.35± 0.98, and that of moderate patients was 7.64±1.25, which was lower than that of mild patients (9.19±1.73; P<0.05), and the serum APN level of severe patients was lower than that of moderate patients (P<0.05). Comparisons of the serum D-D and NLR levels revealed that the serum D-D and NLR in severe patients were 3.49±0.72 and 2.86±0.58, respectively, and those in moderate patients were 3.02±0.63 and 2.24±0.46, respectively, both of which were greater than those in mild patients, which were 2.43±0.51 and 1.71±0.33 (P<0.05). The levels of serum D-D and the NLR were greater in severe patients than in moderate patients (P<0.05). Spearman correlation analysis revealed that the severity of disease in diabetic foot ulcer infection patients was positively related to the serum D-D level and NLR (r=0.387, P<0.001; r=0.461, P<0.001) and negatively related to the serum APN level (r=-0.414, P<0.001). ROC analysis revealed that the optimal cutoff values of the serum APN, D-D and NLR for predicting poor prognosis in patients were 5.73 mg/L, 3.06 mg/L and 2.12, respectively; the sensitivities were 78.57%, 82.14% and 85.71%, respectively; and the specificities were 76.56%, 67.19% and 73.44%, respectively. The areas under the curve (AUCs) were 0.793, 0.784, and 0.818, respectively. The specificity and AUC of the combination of the three methods were 98.44% and 0.918, respectively. Conclusions: Serum APN and D-D levels and the NLR in patients with diabetic foot ulcer infection are related to disease severity. The serum APN, D-D and NLR can be used as sensitive indicators for predicting poor patient prognosis.
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