Abstract：
BACKGROUND: At present, there is no clinical study to elucidate the correlation between vitamin D deficiency and the incidence of diabetic foot osteomyelitis (DFO).This study aims to clarify levels of 25-hydroxyvitamin D [25(OH)VD] in peripheral blood and vitamin D receptor (VDR) expression in wound margin tissues (T-VDR) of patients with type 2 diabetes mellitus (T2DM) with diabetic foot ulcer (DFU) and DFO, and to determine its correlation with treatment outcomes of DFU and DFO, and and its value as a potential biomarker for the diagnosis of DFU and DFO.
METHODS: 156 T2DM patients with DFU (DFU group), 100 T2DM patients without DFU (T2DM group), and 100 healthy controls (NC group). The DFU group patients were subdivided into DFO (n = 80) and NDFO groups (n = 76). The level of serum 25(OH)VD was measured via chemiluminescence immunoassay, and T-VDR expression level was determined by quantitative real-time PCR.
RESULTS: The levels of serum 25(OH)VD in the DFU group were significantly lower than the T2DM group [(10.3 (5.8, 18.7) vs 15.7 (8.6, 24.6) ng/mL, P = 0.002)]. Similarly, the levels of serum 25(OH)VD and T-VDR expression in the DFO group were statistically lower than the NDFO group [9.2 (5.2, 20.5) vs 12.8 (6.9, 22.1) ng/mL, P = 0.006)], [1.96 (0.61, 3.97) vs 3.11 (1.36, 5.11), P = 0.004)], respectively. Furthermore, the levels of serum 25(OH)VD and T-VDR expression in DFU patients were positively correlated with the ulcer healing rate of foot ulcer after 8 weeks of treatment ( P = 0.031, P = 0.016, respectively). Multivariate logistic regression analysis showed that low level of serum 25(OH)VD was an independent risk factor for DFU and DFO (ORDFU = 2.42, ORDFO = 3.05, P = 0.008, 0.001, respectively), and decreased T-VDR expression level was an independent risk factor for DFO (OR = 2.83, P = 0.004). Meanwhile, the ROC curve analysis indicated that the AUC of serum 25(OH)VD level for the diagnosis of DFU and DFO was 0.821 (95% CI, 0.754-0.886, P < 0.001) and 0.786 (95%CI, 0.643-0.867, P < 0.001), respectively. When establishing a diagnosis of DFO, the AUC of T-VDR expression level was 0.703 (95%CI: 0.618-0.853, P < 0.001).
CONCLUSIONS: The levels of serum 25(OH)VD and T-VDR expression in DFU and DFO decreased. Serum 25(OH)VD and T-VDR are potentially valuable biomarkers for diagnosis and prognosis of DFU and DFO. .
METHODS: 156 T2DM patients with DFU (DFU group), 100 T2DM patients without DFU (T2DM group), and 100 healthy controls (NC group). The DFU group patients were subdivided into DFO (n = 80) and NDFO groups (n = 76). The level of serum 25(OH)VD was measured via chemiluminescence immunoassay, and T-VDR expression level was determined by quantitative real-time PCR.
RESULTS: The levels of serum 25(OH)VD in the DFU group were significantly lower than the T2DM group [(10.3 (5.8, 18.7) vs 15.7 (8.6, 24.6) ng/mL, P = 0.002)]. Similarly, the levels of serum 25(OH)VD and T-VDR expression in the DFO group were statistically lower than the NDFO group [9.2 (5.2, 20.5) vs 12.8 (6.9, 22.1) ng/mL, P = 0.006)], [1.96 (0.61, 3.97) vs 3.11 (1.36, 5.11), P = 0.004)], respectively. Furthermore, the levels of serum 25(OH)VD and T-VDR expression in DFU patients were positively correlated with the ulcer healing rate of foot ulcer after 8 weeks of treatment ( P = 0.031, P = 0.016, respectively). Multivariate logistic regression analysis showed that low level of serum 25(OH)VD was an independent risk factor for DFU and DFO (ORDFU = 2.42, ORDFO = 3.05, P = 0.008, 0.001, respectively), and decreased T-VDR expression level was an independent risk factor for DFO (OR = 2.83, P = 0.004). Meanwhile, the ROC curve analysis indicated that the AUC of serum 25(OH)VD level for the diagnosis of DFU and DFO was 0.821 (95% CI, 0.754-0.886, P < 0.001) and 0.786 (95%CI, 0.643-0.867, P < 0.001), respectively. When establishing a diagnosis of DFO, the AUC of T-VDR expression level was 0.703 (95%CI: 0.618-0.853, P < 0.001).
CONCLUSIONS: The levels of serum 25(OH)VD and T-VDR expression in DFU and DFO decreased. Serum 25(OH)VD and T-VDR are potentially valuable biomarkers for diagnosis and prognosis of DFU and DFO. .
摘要：
背景：目前，目前尚无临床研究阐明维生素D缺乏与糖尿病足骨髓炎(DFO)发病率之间的相关性.本研究旨在阐明2型糖尿病（T2DM）合并糖尿病足溃疡（DFU）和DFO患者外周血25-羟维生素D[25（OH）VD]水平和伤口边缘组织维生素D受体（VDR）表达水平。并确定其与DFU和DFO治疗结果的相关性，及其作为DFU和DFO诊断的潜在生物标志物的价值。
方法：156例T2DM伴DFU患者（DFU组），100例无DFU的T2DM患者（T2DM组），和100名健康对照（NC组）。DFU组患者分为DFO组(n=80)和NDFO组(n=76)。血清25(OH)VD的水平通过化学发光免疫分析，通过定量实时PCR测定T-VDR表达水平。
结果：DFU组的血清25（OH）VD水平明显低于T2DM组[（10.3（5.8，18.7）vs15.7（8.6，24.6）ng/mL，P=0.002)]。同样，DFO组血清25(OH)VD和T-VDR表达水平明显低于NDFO组[9.2(5.2,20.5)vs12.8(6.9,22.1)ng/mL,P=0.006)],[1.96（0.61，3.97）vs3.11（1.36，5.11），P=0.004)],分别。此外，DFU患者治疗8周后血清25(OH)VD和T-VDR表达水平与足溃疡愈合率呈正相关(P=0.031,P=0.016)。多因素logistic回归分析显示,低水平的血清25(OH)VD是DFU和DFO的独立危险因素(ORDFU=2.42,ORDFO=3.05,P=0.008,0.001)。T-VDR表达水平降低是DFO的独立危险因素(OR=2.83,P=0.004)。同时,ROC曲线分析表明，血清25（OH）VD水平诊断DFU和DFO的AUC分别为0.821（95％CI，0.754-0.886，P<0.001）和0.786（95CI，0.643-0.867，P<0.001）。分别。在诊断DFO时，T-VDR表达水平的AUC为0.703(95CI:0.618~0.853,P<0.001)。
结论：DFU和DFO患者血清25(OH)VD和T-VDR表达水平降低。血清25（OH）VD和T-VDR是DFU和DFO诊断和预后的潜在有价值的生物标志物。.
方法：156例T2DM伴DFU患者（DFU组），
结果：DFU组的血清25（OH）VD水平明显低于T2DM组[（10.3（5.8，18.7）vs15.7（8.6，24.6）ng/mL，
结论：DFU和DFO患者血清25(OH)VD和T-VDR表达水平降低。
