title: Diabetic foot osteomyelitis: bone markers and treatment outcomes.
abstract: OBJECTIVE
  Novel bone turnover markers could help with the diagnosis and monitoring of osteomyelitis patients. We compared levels of two bone turnover markers, serum amino-terminal telopeptides (NTx) and bone alkaline phosphatase (BAP), in diabetic patients with and without osteomyelitis.
  
  
  METHODS
  Matched case-control study was conducted with diabetic patients with and without osteomyelitis. Cases not undergoing immediate amputation were followed with repeat measurements after osteomyelitis treatment and for outcome determination.
  
  
  RESULTS
  Analysis included 54 subjects, 27 cases and 27 controls. Median BAP levels were similar between cases and controls at enrollment (p=.55) as were median NTx levels (p=.43). Cases with follow-up data (n=18) had similar bone marker levels at enrollment and 6 weeks. No significant differences in BAP or NTx levels at enrollment or follow-up were seen between cases with poor versus favorable outcomes.
  
  
  CONCLUSIONS
  No differences in NTx or BAP levels were seen between cases and controls. Cases with follow-up data had similar levels at enrollment and 6 weeks. Lack of difference may be due to small sample size, small areas of bone involved in foot osteomyelitis, or limitations of these specific markers. More research is needed.
authors.affiliation: Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO 63110, United States.
authors.forename: Humaa A
authors.initials: HA
authors.lastname: Nyazee
authors.forename: Kristina M
authors.initials: KM
authors.lastname: Finney
authors.forename: Molly
authors.initials: M
authors.lastname: Sarikonda
authors.forename: Dwight A
authors.initials: DA
authors.lastname: Towler
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Johnson
authors.forename: Hilary M
authors.initials: HM
authors.lastname: Babcock
mesh_terms: D000328:Adult; D000465:Algorithms; D000469:Alkaline Phosphatase / Q000032:analysis / Q000097:blood / Q000378:metabolism; D015415:Biomarkers / Q000032:analysis* / Q000378:metabolism; D001842:Bone and Bones / Q000378:metabolism; D016022:Case-Control Studies; D015331:Cohort Studies; D024042:Collagen Type I / Q000032:analysis / Q000097:blood / Q000378:metabolism; D017719:Diabetic Foot / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D010455:Peptides / Q000032:analysis / Q000097:blood / Q000378:metabolism; D011379:Prognosis; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D000469:Alkaline Phosphatase