Higher Serum Levels of Lipoprotein-Associated Phospholipase A2 are Associated with Diabetic Foot Osteomyelitis

Abstract

Background

Diabetic foot osteomyelitis (DFO) is often difficult to detect in its early stages, making diagnosis challenging. This study is to investigate the relationship between lipoprotein-associated phospholipase A2 (Lp-PLA2) and DFO, while also evaluating the potential of Lp-PLA2 as an early diagnostic biomarker for DFO.

Methods

A total of 265 patients with type 2 diabetes complicated by diabetic foot infections were selected for the study. Participants were divided into the Non-DFO group (184 cases) and the DFO group (81 cases). Serum Lp-PLA2 levels were measured. Logistic regression analysis was utilized to identify risk factors associated with DFO. Receiver Operating Characteristic curve analysis was performed to assess the diagnostic value of Lp-PLA2 in patients with DFO.

Results

Lp-PLA2 in the DFO group were significantly higher than those in the Non-DFO group (P < .05). Lp-PLA2 (OR, 1.015 [95% CI, 1.011-1.019]; P < .001), lower extremity arterial disease (OR, 2.453 [95% CI, 1.147-5.247]; P < .05), and ESR (OR, 1.042 [95% CI, 1.026-1.059]; P < .001) were the independent risk factors for DFO. Lp-PLA2 and ESR were shown to be associated with DFO, with their respective areas under the curve (AUC) being 0.787 and 0.683. The sensitivity and specificity of Lp-PLA2 were 65.4% and 82.6%, respectively, while those of ESR were 48.1% and 95.1%. Combined Lp-PLA2 and ESR showed the best diagnostic performance (AUC 0.858, sensitivity 79.0%, specificity 84.2%).

Conclusion

As a preliminary one, Lp-PLA2 demonstrates significant diagnostic value for DFO. The combination of Lp-PLA2 and ESR can significantly improve diagnostic accuracy of DFO.