Diagnostic performance of serum bone turnover marker lysylpyridinoline in diabetic foot osteomyelitis: a preliminary study

O. G. Hayes, V. Vangaveti, U. Malabu
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Abstract

Objectives: The aim of the study was to determine whether serum levels of lysylpyridinoline (LP) differ between diabetic foot osteomyelitis (DFO) and diabetic foot ulcers without osteomyelitis (cellulitis). Methods: A case controlled study was designed comparing the aforementioned groups. Subjects were classified as osteomyelitis and controls based on the International Working Group diagnostic criteria. Serum LP samples were analysed using enzyme linked immunosorbent assay. Results: The serum LP levels were significantly higher in the DFO group (n: 16) than the control group (n: 11): LP median ± SD of 9.3 ± 3.5 nmol/l, interquartile range (IQR) 6.8-11.2 in DFO compared to 2.1 nmol/l 3.5, IQR 0.7-4.2 in the controls, p=0.001. The receiver operator characteristic curve in the DFO was 0.9. The diagnostic sensitivity, specificity, positive and negative predictive values were 100%, 77.8%, 89.0% and 100% respectively. Conclusions: This appears to be the first evidence of serum LP elevation in diabetic foot osteomyelitis with potential diagnostic value in clinical setting.
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血清骨转换标志物赖氨酸吡啶在糖尿病足骨髓炎中的诊断性能:初步研究
目的:本研究的目的是确定糖尿病足骨髓炎(DFO)和无骨髓炎(蜂窝组织炎)的糖尿病足溃疡患者血清赖基吡啶啉(LP)水平是否存在差异。方法:设计病例对照研究,对上述两组进行比较。受试者根据国际工作组诊断标准分为骨髓炎组和对照组。采用酶联免疫吸附法分析血清LP样品。结果:DFO组(n: 16)血清LP水平显著高于对照组(n: 11): LP中位数±SD为9.3±3.5 nmol/l,四分位数间差(IQR)为6.8 ~ 11.2,对照组为2.1 nmol/l 3.5, IQR为0.7 ~ 4.2,p=0.001。DFO的受者操作者特征曲线为0.9。诊断敏感性为100%,特异性为77.8%,阳性预测值为89.0%,阴性预测值为100%。结论:这似乎是糖尿病足骨髓炎患者血清LP升高的第一个证据,具有潜在的临床诊断价值。
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