Expression of serum TLR-9 and Cys-C in diabetic foot infection and analysis of the risk factors
Objective To study the expression of serum toll-like receptor 9(TLR-9),cystatin C(Cys-C)and the risk factors in diabetic foot infection.Methods A total of 80 patients with diabetic foot admitted to the Wuhu Hospital of Traditional Chinese Medicine from January 2016 to March 2023 were selected and divided into infected group(22 cases)and uninfected group(58 cases)according to whether the patients were co-infected.Serum TLR-9 and Cys-C levels were compared between infected group and uninfected group,and the risk factors of diabetic foot co-infected patients were analyzed by multivariate logistic analysis.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of serum TLR-9 and Cys-C levels in diabetic foot infection.Results Univariate analysis showed no significant differences in age,gender,body mass index,course of disease,hypertension and coronary heart disease between the two groups(P＞0.05).There were significant differences in the number of ulcers,vascular complications and osteomyelitis between the two groups(x2=12.406,7.918,11.349;all P＜0.05).Serum levels of TLR-9 and Cys-C in infected group were significantly higher than those in uninfected group(t=12.508,3.916;all P＜0.05).Multivariate logistic regression analysis showed that the number of ulcers,vascular complications,osteomyelitis,serum TLR-9 and Cys-C levels were all risk factors for diabetic foot infection(P＜0.05).ROC results showed that the area under the curve(AUC)of serum TLR-9 predicting diabetic foot co-infection was 0.834,with the sensitivity of 86.70％,and the specificity of 91.20％;the AUC of Cys-C predicting diabetic foot co-infection was 0.875,with the sensitivity of 88.60％,the specificity of 84.40％.The AUC of combined detection for predicting diabetic foot co-infection was 0.926,with the sensitivity of 96.70％,and the specificity of 97.00％.Combined detection had higher sensitivity and specificity than single detection(all P＜0.05).Conclusion There were many risk factors of infection in patients with diabetic foot co-infection,and the combined detection of serum TLR-9 and Cys-C levels had high predictive value,which should be paid close attention in clinical practice to reduce the incidence of infection.
Diabetic footToll-like receptor 9Cysteine protease inhibitor C
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