Elamurugan T P, Uday Chappa

CLINICAL UTILITY OF SERUM LYSYLPYRIDINOLINE LEVELS IN THE DIAGNOSIS OF DIABETIC FOOT OSTEOMYELITIS – A COMPARATIVE CROSSSECTIONAL ANALYTICAL STUDY.

  • General Medicine
  • General Earth and Planetary Sciences
  • General Environmental Science
  • General Medicine
  • Ocean Engineering
  • General Medicine
  • General Medicine
  • General Medicine
  • General Medicine
  • General Earth and Planetary Sciences
  • General Environmental Science
  • General Medicine
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Background: The current diagnostic methods for Diabetic foot osteomyelitis have signicant concerns, including invasiveness(biopsy), extended lag-time to positivity(radiograph) and poor sensitivity. Lysylpyridinoline is a serum bone turnover marker released during bone resorption. It has high sensitivity and specicity. Early detection of diabetic foot osteomyelitis using serum Lysylpyridinoline levels may reduce the need for amputation. Aims and objectives: To assess diagnostic utility of serum Lysylpyridinoline(LP) levels in diabetic foot osteomyelitis. Method: The study was conducted as cross sectional, comparative analytical study from April 2019 to January 2021. Patients who had positive bone to probe test and bone biopsy specimen culture were included in osteomyelitis group(DFO). Patients who had negative results in both were included in diabetic foot ulcer group(DFU). Serum Lysylpyridinoline level was compared between the groups. Results: A total of 120 participants were included in the study, 60 in each group. Mean corrected serum LP levels were higher in osteomyelitis (5.113±1.93 ng/ml) than DFU group (4.03±1.47 ng/ml) and the difference was statistically signicant(P<0.05). Receiver Operating characteristic curve(ROC) was plotted for demonstrating its diagnostic value. The area under the curve was 0.733(95%CI: 0.643-0.824) and found to be statistically signicant. The cut off value was 3.959 ng/ml with sensitivity of 81.7%, specicity of 75.56% to differentiate between DFU with and without osteomyelitis. Conclusion: Serum Lysylpyridinoline levels were signicantly higher in patients with diabetic foot osteomyelitis patients. Hence can be used for screening and diagnosing of diabetic foot osteomyelitis.

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