Inflammatory Markers in Diabetic Foot Infection: A Meta-Analysis

Abstract

Introduction. Diabetic foot infection is a serious and painful process for patients with diabetes, and the considerable morbidity associated with the condition warrants attention. Effective inflammatory markers may become important in the detection of diabetic foot infection. Objective. The goal of the research was to systematically assess the function of inflammatory markers in the detection of diabetic foot infection. Methods. Online databases including PubMed, SpringerLink, and Web of Science were searched. The quality of research and data was assessed using the Newcastle-Ottawa Scale. A random-effects model was used to compare changes in inflammatory markers between patients with infected diabetic foot (IDF) and patients with non-infected diabetic foot. Results. Ten studies with 785 participants were included in the systematic review. The study analyzed 3 inflammatory markers: white blood cell (WBC) count, C-reactive protein (CRP) level, and procalcitonin (PCT) level. The meta-analysis indicated that mean WBC count (standardized mean differences [SMD]: 0.51, 95% CI: 0.23, 0.79; P < .0001), mean CRP level (SMD: 1.05, 95% CI: 0.60, 1.50; P < .0001) and mean PCT level (SMD: 0.80, 95% CI: 0.36, 1.24; P < .0001) were higher in patients with IDF. The differences were statistically significant, but the funnel plots indicated the existence of publication bias. Conclusions. The meta-analysis further confirmed the significant association between inflammatory markers and diabetic foot infection. It also confirmed that WBC count, CRP level, and PCT level can be used as laboratory auxiliary indexes in the detection of diabetic foot infection, providing information for improved diagnosis and prevention.