The Correlation Analysis Between Neutrophil To Lymphocyte Ratio And The Clinical Grade Of Diabetic Foot

Objective: To investigate the correlation between the neutrophil / lymphocyte ratio(NLR)and the Wagner clinical grade of diabetic foot(DF),analyze whether the NLR is predictive of Wagner clinical grade for diabetic foot,and find the best predictive value at the same time.The aim is provideing timely and effective reference for prevention and individualized clinical treatment of diabetic foot.Methods: We retrospectively analyzed the clinical data of 199 patients with diabetes risk factor foot and diabetic foot ulcer admitted to the First Affiliated Hospital of The South of China University from January 2015 to June 2019.The study recorded patient’s age,gender,duration of diabetes,foot condition at admission,Neutrophil count,Lymphocyte count,etc.According to the foot condition at the time of admission,the patient was divided into Wagner grade 0-V group strictly according to Wagner clinical classification.Single factor analysis of variance was used to analyze the NLR between multiple groups,LSD analysis was used to compare the NLRs between the two groups,and Spearman correlation analysis was used to analyze the correlation between different Wagner clinical grades,NLR,age,and the duration of diabetes.The relevant scatter plots were drawn;the ROC curve of the NLR was plotted to analyze the predictability and best predictive value of the NLR for the clinical grade of Wagner for diabetic foot;Chi-square test was used for comparison of count data and t test was used for comparison of measurement data.Results: 1.The NLR between Wagner clinical grades of diabetic foot were significant and positively correlated(R> 0,P <0.05).The differences in the grade 0,I,II,and III groups were compared with the IV and V groups,respectively.Significant(P <0.05),there was no significant difference between grades 0,I,II,and III(P> 0.05),and there was a significant difference between grades IV and V(P <0.05);the NLR value of the grade V group was biggest.2.The area of the NLR under the ROC characteristic curve constructed by Wagner grade 0,I,IV,and V diabetic foot is 0.904(95% CI: 0.863-0.944;critical value: 3.75;P = 0.000),0.787(95% CI: 0.666-0.909;critical value: 3.27;P = 0.001),0.792(95% CI: 0.728-0.857;critical value: 4.13;P = 0.000),0.851(95% CI: 0.761-0.941;critical value : 6.38;P = 0.001).P <0.05 indicates statistical significance.3.The correlations between Wagner clinical grade,NLR and duration of diabetes were 0.506 and 0.424(P <0.05),which were statistically significant.4.The correlations between Wagner clinical grade,NLR and patient age were 0.254 and 0.013(P <0.05),which were statistically significant.5.In this study,the difference in DFU between single lower limbs(left or right foot)and both lower limbs was statistically significant(P <0.05),while their NLR levels were not statistically different(P> 0.05).Conclusions: 1.There is a high positive correlation between Wagner clinical grade of diabetic foot and NLR(P <0.05,R = 0.744).2.NLR can be used to predict the Wagner clinical grade of diabetic foot.3.Diabetes duration was positively correlated with Wagner clinical grade and NLR of diabetic foot(R= 0.506,0.424,P <0.05).Patients’ age was also positively correlated with Wagner clinical grade and NLR of diabetic foot(R=0.245,0.175,P <0.05);4.In this study,the probability of foot ulcers in unilateral limbs of patients with diabetes was higher than that of bilateral ulcers.