Abstract：
The aim of this study was to evaluate the diagnostic characteristics of biomarker for diabetic foot osteomyelitis (DFO). We searched PubMed, Scopus, Embase and Medline for studies who report serological markers and DFO before December 2022. Studies must include at least one of the following diagnostic parameters for biomarkers: area under the curve, sensitivities, specificities, positive predictive value, negative predictive value. Two authors evaluated quality using the Quality Assessment of Diagnostic Accuracy Studies tool. We included 19 papers. In this systematic review, there were 2854 subjects with 2134 (74.8%) of those patients being included in the meta-analysis. The most common biomarkers were erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and procalcitonin (PCT). A meta-analysis was then performed where data were evaluated with Forrest plots and receiver operating characteristic curves. The pooled sensitivity and specificity were 0.72 and 0.75 for PCT, 0.72 and 0.76 for CRP and 0.70 and 0.77 for ESR. Pooled area under the curves for ESR, CRP and PCT were 0.83, 0.77 and 0.71, respectfully. Average diagnostic odds ratios were 16.1 (range 3.6-55.4), 14.3 (range 2.7-48.7) and 6.7 (range 3.6-10.4) for ESR, CRP and PCT, respectfully. None of the biomarkers we evaluated could be rated as \'outstanding\' to diagnose osteomyelitis. Based on the areas under the curve, ESR is an \'excellent\' biomarker to detect osteomyelitis, and CRP and PCT are \'acceptable\' biomarkers to diagnose osteomyelitis. Diagnostic odds ratios indicate that ESR, CRP and PCT are \'good\' or \'very good\' tools to identify osteomyelitis.
摘要：
这项研究的目的是评估生物标志物对糖尿病足骨髓炎（DFO）的诊断特征。我们搜索了PubMed,Scopus,Embase和Medline用于在2022年12月之前报告血清学标志物和DFO的研究。研究必须至少包括以下生物标志物的诊断参数之一：曲线下面积，敏感性，特殊性，正预测值，负预测值。两位作者使用诊断准确性研究的质量评估工具评估了质量。我们收录了19篇论文。在这次系统审查中，有2854名受试者,其中2134名(74.8%)被纳入荟萃分析.最常见的生物标志物是红细胞沉降率（ESR），C反应蛋白（CRP）和降钙素原（PCT）。然后进行荟萃分析，其中使用Forrest图和接收器工作特征曲线评估数据。PCT的合并敏感性和特异性分别为0.72和0.75，CRP为0.72和0.76，ESR为0.70和0.77。ESR曲线下的集合面积，CRP和PCT分别为0.83、0.77和0.71。平均诊断赔率比为16.1（范围3.6-55.4），ESR为14.3（范围2.7-48.7）和6.7（范围3.6-10.4），CRP和PCT,恭敬地。我们评估的生物标志物均不能被评为诊断骨髓炎的“杰出”。根据曲线下的面积，ESR是检测骨髓炎的“极好的”生物标志物，CRP和PCT是诊断骨髓炎的“可接受的”生物标志物。诊断优势比表明ESR，CRP和PCT是鉴别骨髓炎的“好”或“非常好”的工具。
