Examining Albumin as a Bioindicator of Healing Capability in Patients With Diabetic Foot Ulcers: A Retrospective Review

Abstract

Introduction. Identifying a bioindicator of healing capacity would be beneficial in guiding treatment of and reducing morbidity in patients with DFU. Hypoalbuminemia is a well-established risk factor for amputation and, thus, a promising candidate. Objective. This study was conducted to examine whether albumin values over a 12-week treatment course for DFU correlated with ulcer size and outcomes. Materials and Methods. A retrospective review was conducted of 793 patients who presented to the Atrium Health Wake Forest Baptist Wound Care and Hyperbaric Center between 2010 and 2022. Sixty-two patients met the inclusion criteria. Albumin values and wound size data were collected monthly over a 12-week treatment course. Results. Initial albumin values were not significantly different between patients healed by 12 weeks compared with nonhealed patients. Healed proportion and average initial ulcer size in patients with at least 1 hypoalbuminemia value (<3.0 g/dL) were not significantly different from those in patients with normal albumin levels. Patients who trended from normoalbuminemia to hypoalbuminemia displayed significantly increased wound sizes compared to patients with albumin changes within the normal range (0.04 cm² and −1.17 cm², respectively; P < .05). Monthly changes in albumin correlated poorly with wound healing (r = 0.144, P = .240), and large negative albumin trends (>0.5 g/dL per month) did not correlate with increased wound sizes compared with stable or positive trends. Conclusion. Albumin’s utility as a bioindicator of short-term healing capability is limited to below-normal values.

The Metabolic Characteristics of Patients at the Risk for Diabetic Foot Ulcer: A Comparative Study of Diabetic Patients with and without Diabetic Foot

“…could not be excluded as critical factors. 36,37 As for renal function, we consistently observed substantial changes in Scr, UA, and eGFR levels (for SCr and eGFR are only mildly impaired…”

“…could not be excluded as critical factors. 36 , 37 As for renal function, we consistently observed substantial changes in Scr, UA, and eGFR levels (for SCr and eGFR are only mildly impaired in the group without DFU), suggesting a decline in renal filtration function in the patients with DFU attributed possibly to the advanced diabetic nephropathy, in that the level of UACR exhibited as the urinary microalbumin stage (UACR: 30–300mg/g), as well as overconsumption status in the group with DFU. 38 , 39 However, no significant differences in BUN and UACR were found between the two groups.…”