Relationship between monocyte to high density lipoprotein-cholesterol ratio and the infection, severity, and prognosis of diabetic foot ulcer / 中华内分泌代谢杂志

ABSTRACT

Objective:The aim of this study was to investigate the relationship between monocyte to high density lipoprotein-cholesterol ratio (MHR) and the infection, severity, and prognosis of diabetic foot ulcer.Methods:A retrospective cohort study of 194 patients with diabetic foot ulcer between September 2016 and August 2018 was conducted at the First Affiliated Hospital of University of South China. The clinical data, glucose and lipids metabolism, renal function, nutritional status, coagulation function, and severity of infection, severity, ischemic, and diagnosis were recorded. The rates of healed ulcer, amputation, and mortality were followed for six months.Results:The higher MHR levels of diabetic foot ulcer patients were accompanied with the higher Wagner grade, infection grade, severity of lower extremity ischemia, and proportion of adverse outcomes ( P trend<0.05). MHR and many traditional risk factors of diabetic foot ulcer (white blood cell count, C-reactive protein, albumin, estimated glomerular filtration rate, and ankle brachial index) were significantly correlated (all P<0.05). After adjustment for potential confounders, multivariate logistics regression analysis showed that MHR levels were positively associated with the occurrence of adverse outcomes [odds ratio ( OR) for the highest quartile vs lowest quartile, 1.52 (95% CI 1.08-3.08), P<0.05]. The receiver operating characteristic (ROC) curve analysis showed that area under the curve (AUC) of high MHR, high C-reactive protein, and low albumin for predicting the occurrence of adverse outcomes in diabetic foot ulcer patients were 0.674 (95% CI 0.581-0.747), 0.703(95% CI 0.615-0.772), and 0.667(95% CI 0.569-0.734), respectively. Conclusion:Elevation of MHR in diabetic foot ulcer patients are positively correlated with the grading of Wagner classification, and the severity of infection and ischemia, and seriously affects the prognosis of patients, suggesting that more attention should be paid to the MHR.