Does obesity affect the diagnostic value of various biomarkers for periprosthetic joint infections? A single center retrospective study.

IF 4.8 2区 医学 Q2 IMMUNOLOGY Frontiers in Cellular and Infection Microbiology Pub Date : 2025-02-18 eCollection Date: 2025-01-01 DOI:10.3389/fcimb.2025.1483503
Wei-Peng Shi, Ya-Ping Jiang, Ting-Yu Wu, Ying-Zhen Wang, Ying-Ze Zhang, Tao Li
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Abstract

Objective: The aim of this study was to examine the impact of obesity on the diagnosis of periprosthetic joint infections (PJI) by assessing the levels and diagnostic efficacy of biomarkers.

Methods: A total of 254 patients were divided into obese group (n=59) and non-obese group (n=195) according to BMI. Each group was further divided into the PJI group and the AF group. Data on CRP, ESR, fibrinogen, D-dimer, CRP-albumin ratio (CAR), CRP-lymphocyte ratio (CLR), and CRP-monocyte ratio (CMR) were collected from all patients. ROC curve was performed to evaluate the diagnostic values of these biomarkers.

Results: The levels of biomarkers were significantly higher in PJI patients compared to the AF patients in both the obese and non-obese groups (P < 0.001), but the levels of biomarkers were similar between the obese and non-obese groups. In the obese group, CRP exhibited the highest diagnostic value (AUC=0.982). In the non-obese group, CAR demonstrated the highest diagnostic value (AUC =0.935). Subgroup analysis showed no significant differences in biomarker levels (P > 0.05).

Conclusions: Obesity did not affect biomarker levels in patients with PJI. But for obese patients, the diagnostic thresholds for CRP and ESR are higher, and clinical diagnosis should be careful to avoid false positives. CRP and CAR were identified as the most effective biomarkers for diagnosing PJI in the obese and non-obese groups, respectively.

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肥胖是否会影响各种生物标志物对假体周围关节感染的诊断价值?单中心回顾性研究。
目的:本研究旨在通过评估生物标志物的水平和诊断效果,探讨肥胖对假体周围关节感染(PJI)诊断的影响。方法:将254例患者按BMI分为肥胖组59例和非肥胖组195例。各组进一步分为PJI组和AF组。收集所有患者的CRP、ESR、纤维蛋白原、d -二聚体、CRP-白蛋白比(CAR)、CRP-淋巴细胞比(CLR)和CRP-单核细胞比(CMR)数据。采用ROC曲线评价这些生物标志物的诊断价值。结果:PJI患者的生物标志物水平在肥胖组和非肥胖组均明显高于AF患者(P < 0.001),但肥胖组和非肥胖组的生物标志物水平相似。在肥胖组中,CRP的诊断价值最高(AUC=0.982)。在非肥胖组,CAR的诊断价值最高(AUC =0.935)。亚组分析显示两组生物标志物水平差异无统计学意义(P < 0.05)。结论:肥胖不影响PJI患者的生物标志物水平。但对于肥胖患者,CRP和ESR的诊断阈值较高,临床诊断应注意避免假阳性。CRP和CAR分别被认为是诊断肥胖组和非肥胖组PJI最有效的生物标志物。
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来源期刊
CiteScore
7.90
自引率
7.00%
发文量
1817
审稿时长
14 weeks
期刊介绍: Frontiers in Cellular and Infection Microbiology is a leading specialty journal, publishing rigorously peer-reviewed research across all pathogenic microorganisms and their interaction with their hosts. Chief Editor Yousef Abu Kwaik, University of Louisville is supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Cellular and Infection Microbiology includes research on bacteria, fungi, parasites, viruses, endosymbionts, prions and all microbial pathogens as well as the microbiota and its effect on health and disease in various hosts. The research approaches include molecular microbiology, cellular microbiology, gene regulation, proteomics, signal transduction, pathogenic evolution, genomics, structural biology, and virulence factors as well as model hosts. Areas of research to counteract infectious agents by the host include the host innate and adaptive immune responses as well as metabolic restrictions to various pathogenic microorganisms, vaccine design and development against various pathogenic microorganisms, and the mechanisms of antibiotic resistance and its countermeasures.
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