Relationships of GNRI and serum 25-hydroxyvitamin D with therapeutic effect of VSD for diabetic foot ulcers
Objective To investigate the relationships between geriatric nutritional risk index(GNRI),serum 25-hydroxyvitamin D[25(OH)D]and the outcome of vacuum sealing drainage(VSD)for diabetic foot ulcer(DFU)patients.Methods Totally 106 patients with DFU who underwent VSD were selected as the DFU group,and they were divided into the ineffective group(27 cases)and the effective group(79 cases)according to the therapeutic effect after VSD;another 55 patients with type 2 diabetes mellitus(T2DM)alone in the same period were selected as the T2DM group,and 55 healthy physical examination volunteers were selected as the control group.GNRI was calculated and serum 25(OH)D was assayed.Multifactorial Logistic regression was used to analyze the factors influencing the postoperative treatment outcome of VSD in patients with DFU,and a receiver operating characteristic curve was used to analyze the assessed value of GNRI combined with serum 25(OH)D on the postoperative treatment outcome of VSD in patients with DFU.Results There were significant differences in GNRI and serum 25(OH)D levels among the DFU group,the T2DM group,and the control group(all P<0.05).GNRI and serum 25(OH)D levels were reduced sequentially in the DFU group,T2DM group,and control group(all P<0.05).Wagner classification grade 4 and elevated HbA1c were independent risk factors for ineffec-tive treatment after VSD in patients with DFU(all P<0.05),and elevated ABI,GNRI,and 25(OH)D were independent protective factors for effective treatment after VSD in patients with DFU(all P<0.05).The area under the curve of GNRI combined with serum 25(OH)D level in assessing the postoperative treatment effect of VSD in patients with DFU was 0.879,which was greater than that of the two alone(0.800 and 0.879,both P<0.05).Conclusion DFU patients with low GNRI and serum 25(OH)D have poor postoperative VSD outcomes,and the combination of the two is of high value in assessing postoperative VSD outcomes in DFU patients.
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