Correlation between the platelet‐to‐lymphocyte ratio and diabetic foot ulcer in patients with type 2 diabetes mellitus

Zhang, Kuanxin; Ding, Sheng; Lyu, Xiaoyu; Tan, Qin; Wang, Zhongjing

doi:10.1002/jcla.23719

Cited by 15 publications

(16 citation statements)

References 22 publications

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“…Biomarkers are valuable tools for these purposes. To date, multiple biomarkers focused on stratifying the risk of developing DFU have been studied, such as creatinine, lipid profile, apolipoproteins, hemoglobin A1c, platelet-to-lymphocyte ratio, and others [ 11 , 12 ]. The lipid profile and apolipoproteins have been associated with complications in cardiovascular and neuropathic diseases, the same ones associated with the development of DFU; given this, several studies have evaluated their association [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Association between Lipid Profile and Apolipoproteins with Risk of Diabetic Foot Ulcer: A Systematic Review and Meta-Analysis

Ulloque-Badaracco

Mosquera-Rojas

Hernández-Bustamante

et al. 2022

International Journal of Clinical Practice

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Background and Aims. Biomarkers are necessary to stratify the risk of diabetic foot ulcers (DFUs). This systematic review and meta-analysis aimed to evaluate the association between the lipid profile and apolipoproteins with the risk of DFU. Methods. A systematic search was conducted in PubMed, Scopus, Cochrane Library, and Web of Science among adult patients. Cohort and case-control studies were included. Random-effects models were used for meta-analyses, and the effects were expressed as odds ratio (OR) and their 95% confidence intervals (CIs). We evaluated publication bias through Egger’s test and funnel plot. Results. A total of 12 cohort studies and 26 case-control studies were included, with 17076 patients. We found that the higher values of total cholesterol (TC), low-density lipoprotein (LDL), triglycerides, and lipoprotein(a) (Lp(a)) were associated with a higher risk of developing DFU (OR: 1.47, OR: 1.47, OR: 1.5, OR: 1.85, respectively). Otherwise, the lower values of HDL were associated with a higher risk of developing DFU (OR: 0.49). Publication bias was not found for associations between TC, HDL, LDL, or TG and the risk of DFU. Conclusions. The high values of LDL, TC, TG, and Lp(a) and low values of HDL are associated with a higher risk of developing DFU. Furthermore, we did not find a significant association for VLDL, ApoA1, ApoB, and ApoB/ApoA1 ratio.

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Section: Introductionmentioning

confidence: 99%

Association between Lipid Profile and Apolipoproteins with Risk of Diabetic Foot Ulcer: A Systematic Review and Meta-Analysis

Ulloque-Badaracco

Mosquera-Rojas

Hernández-Bustamante

et al. 2022

International Journal of Clinical Practice

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“…28 Similarly, Yue et al found that PLR was significantly increased during the onset of diabetic retinopathy (DR), 28 while Zhang et al reported that the PLR for patients with diabetic foot ulcers (DFU) increased significantly and was positively correlated with Wagner DFU grade. 29 As a potential biomarker reflecting inflammation responses, many studies have reported that PLR is positively correlated with traditional inflammatory markers. Since PLR is calculated as the ratio of platelets to lymphocytes, a high PLR can either occur as a result of the platelet count being high or the lymphocyte count being low.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Platelet-to-Lymphocyte Ratio Predicts the Presence of Diabetic Neurogenic Bladder

Liu¹,

Wang²,

Wang³

et al. 2022

DMSO

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Diabetic neurogenic bladder (DNB) has been widely recognized in recent years. It is common in patients with long-term diabetes and may also lead to many severe complications. Although there has been widespread evidence that inflammation is involved in the development of some diabetic complications, there is little evidence that this can also occur in the bladder. In recent years, platelet-to-lymphocyte ratio (PLR) and neutrophil-tolymphocyte ratio (NLR) have been viewed as potential novel markers of inflammatory responses. This study was designed to evaluate the relationship between the presence of DNB and the PLR and NLR. Patients and Methods: A total of 371 cases of T2DM patients were included in this retrospective study. Patients were divided into two groups, with 115 diabetic subjects diagnosed with diabetic neurogenic bladder and 256 control subjects without DNB. The independent predictors of DNB were analyzed using logistic regression. Results: Compared with patients without DNB, the mean PLR and NLR were significantly higher in those with DNB (p < 0.001). Based on the logistic regression, PLR was found to be an independent risk factor for DNB (odds ratio [OR]: 1.408, 95% confidence interval [CI]: 1.248-1.617). From the receiver operating characteristic (ROC) curve, using PLR as indicative of DNB was expected to be 101.1949, and it generated a sensitivity and specificity value of 89.6% and 23.4%, respectively. The area under the curve (AUC) was also found to be 0.899 (95% CI: 0.865-0.932). Conclusion:In our study, PLR and NLR were significantly higher for patients with DNB. The PLR was found to be a risk factor in the presence of DNB after correcting for possible confounding factors. Considering the severe complications associated with DNB, patients with elevated PLR should be seriously cared for in clinics.

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“…Some studies researched the predictive value of both ratios for the occurrence of diabetic foot complications such as osteomyelitis, amputation, re-amputation and mortality. [22][23][24] Other authors used the P/L ratio to highlight the inflammatory state induced by the presence of DFU compared to those without, 25,26 or their predictive value for diabetic wound healing. 27 Yapici et al compared N/L ratio between three groups of patients with DFI who were treated either with antibiotics alone, debridement or amputation; however, and unlike our series, each group included a number of patients with osteomyelitis.…”

Section: Nl Lm and Pl Ratios Outcomesmentioning

confidence: 99%

Basic haematological tests as inflammatory performance markers of patients treated either by conservative surgery or minor amputation for infected diabetic foot ulcers

Yammine,

Abou Orm,

Mouawad

et al. 2023

Wound Repair Regeneration

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Basic inflammatory markers have been extensively studied to differentiate between non‐infected and infected diabetic foot ulcers (DFUs). Very rarely, basic haematological tests such as white cell count (WCC) and platelet counts were used as performance markers for DFU infection severity. The aim is to investigate these biomarkers in patients with DFU treated exclusively with surgery. In this retrospective comparative study, we included 154 procedures comparing a conservative surgery group (n = 66 for infected DFU) and a minor amputation group (n = 88 for infected DFU with osteomyelitis). Outcomes were set as the preoperative values of: WCC, neutrophils (N), lymphocytes (L), Monocytes (M), Platelets (P), red cell distribution width (RDW) and the ratios N/L, L/M and P/L. Area under curve (AUC) of the receiver operating characteristic (ROC) was calculated based on the diagnosis of minor amputation as a positive result. Cutoff point values with the highest sensitivity and specificity were obtained for each outcome. The highest AUC values were for WCC (0.68), neutrophils (0.68), platelets (0.7) and P/L ratio (0.69) with corresponding cut‐off values of 10,650/mm3, 76%, 234,000/mcL and 265, respectively. The highest sensitivity was for the platelet count (81.5%) while the highest specificity was for L/M (89%) and P/L ratios (87%). Postoperative values showed similar results. Simple routine blood tests could serve as inflammatory performance markers to help predict the severity of infection in patients treated surgically for infected DFU.

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Correlation between the platelet‐to‐lymphocyte ratio and diabetic foot ulcer in patients with type 2 diabetes mellitus

Cited by 15 publications

References 22 publications

Association between Lipid Profile and Apolipoproteins with Risk of Diabetic Foot Ulcer: A Systematic Review and Meta-Analysis

Association between Lipid Profile and Apolipoproteins with Risk of Diabetic Foot Ulcer: A Systematic Review and Meta-Analysis

Platelet-to-Lymphocyte Ratio Predicts the Presence of Diabetic Neurogenic Bladder

Basic haematological tests as inflammatory performance markers of patients treated either by conservative surgery or minor amputation for infected diabetic foot ulcers

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