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High cystatin C levels predict undesirable outcome for diabetic foot ulcerations
Author(s) -
Ai Ligen,
Hu Yanyun,
Zhang Xiaoyan,
Zeng Hui,
Zhao Jun,
Zhao Jungong,
Chai Yimin,
Lu Junxi,
Tang Junling,
Bao Yuqian,
Liu Fang,
Jia Weiping
Publication year - 2016
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/wrr.12419
Subject(s) - medicine , cystatin c , quartile , diabetic foot ulcer , gastroenterology , diabetes mellitus , renal function , diabetic foot , cohort , population , surgery , endocrinology , confidence interval , environmental health
We investigated the relationship between serum cystatin C levels and the prognosis of diabetic foot ulcerations (DFU). A population‐based cohort study involving 1018 patients with type 2 diabetes was conducted. These patients recruited and divided into two groups: nondiabetic foot ulcer group (NDF, n = 865, 85.5%) and diabetic foot ulcer group (DFU, n = 147, 14.5%).After a 1‐year‐follow‐up, DFUs were grouped into healing ( n = 110, 74.8%) and nonhealing ( n = 37, 25.2%) group based on the clinical prognosis. Compared with the healing group, the nonhealing group were older, had long diabetic duration and had significantly increased serum cystatin C concentrations in DFU ( p < 0.01). After adjustments for age, diabetes duration, renal function and infection control, multiple logistical regression analysis revealed that cystatin C remained associated increased risk of undesirable DFU outcome (OR = 7.279, 95% CI: 1.299–40.784, p < 0.05). When divided into quartiles according to cystatin C levels, the healing rate of Quartile 4 was significantly lower (57.9%) compared with other groups ( p < 0.01). The odd is ratio (OR) analysis showed that the risk of undesirable DFU outcome in Quartile 4 was significantly higher (OR = 4.554, 95% CI: 3.14–5.12, p < 0.05) compared with that in Quartile 1. We concluded that there was a strong and independent association between serum cystatin C and diabetic foot ulceration prognosis, cystatin C > 1.35 mg/L predicts more than sixfold increased risk of incurable foot ulceration.