title: High cystatin C levels predict undesirable outcome for diabetic foot ulcerations.
abstract: We investigated the relationship between serum cystatin C levels and the prognosis of diabetic foot ulcerations (DFU). A population-based cohort study involving 1018 patients with type 2 diabetes was conducted. These patients recruited and divided into two groups: nondiabetic foot ulcer group (NDF, n = 865, 85.5%) and diabetic foot ulcer group (DFU, n = 147, 14.5%).After a 1-year-follow-up, DFUs were grouped into healing (n = 110, 74.8%) and nonhealing (n = 37, 25.2%) group based on the clinical prognosis. Compared with the healing group, the nonhealing group were older, had long diabetic duration and had significantly increased serum cystatin C concentrations in DFU (p < 0.01). After adjustments for age, diabetes duration, renal function and infection control, multiple logistical regression analysis revealed that cystatin C remained associated increased risk of undesirable DFU outcome (OR = 7.279, 95% CI: 1.299-40.784, p < 0.05). When divided into quartiles according to cystatin C levels, the healing rate of Quartile 4 was significantly lower (57.9%) compared with other groups (p < 0.01). The odd is ratio (OR) analysis showed that the risk of undesirable DFU outcome in Quartile 4 was significantly higher (OR = 4.554, 95% CI: 3.14-5.12, p < 0.05) compared with that in Quartile 1. We concluded that there was a strong and independent association between serum cystatin C and diabetic foot ulceration prognosis, cystatin C > 1.35 mg/L predicts more than sixfold increased risk of incurable foot ulceration.
authors: Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology & Metabolism, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Disease, Shanghai Institute for Diabetes, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital.
authors: Ligen
authors: L
authors: Ai
authors: Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology & Metabolism, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Disease, Shanghai Institute for Diabetes, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital.
authors: Yanyun
authors: Y
authors: Hu
authors: Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology & Metabolism, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Disease, Shanghai Institute for Diabetes, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital.
authors: Xiaoyan
authors: X
authors: Zhang
authors: Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology & Metabolism, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Disease, Shanghai Institute for Diabetes, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital.
authors: Hui
authors: H
authors: Zeng
authors: The Multi-disciplinary Collaborative Diabetic Foot Group of Shanghai Clinical Center of Diabetes, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Department of Vascular Surgery, The Multi-disciplinary Collaborative Diabetic Foot Group of Shanghai Clinical Center of Diabetes, Shanghai Clinical Center of Trauma and Orthopedics, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital.
authors: Jun
authors: J
authors: Zhao
authors: The Multi-disciplinary Collaborative Diabetic Foot Group of Shanghai Clinical Center of Diabetes, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Department of Interventional Radiology, The Multi-disciplinary Collaborative Diabetic Foot Group of Shanghai Clinical Center of Diabetes, Shanghai Clinical Center of Trauma and Orthopedics, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital.
authors: Jungong
authors: J
authors: Zhao
authors: Department of Orthopedics, The Multi-disciplinary Collaborative Diabetic Foot Group of Shanghai Clinical Center of Diabetes, Shanghai Clinical Center of Trauma and Orthopedics, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital.
authors: Yimin
authors: Y
authors: Chai
authors: Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology & Metabolism, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Disease, Shanghai Institute for Diabetes, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital.
authors: Junxi
authors: J
authors: Lu
authors: Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology & Metabolism, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Disease, Shanghai Institute for Diabetes, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital.
authors: Junling
authors: J
authors: Tang
authors: Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology & Metabolism, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Disease, Shanghai Institute for Diabetes, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital.
authors: Yuqian
authors: Y
authors: Bao
authors: Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology & Metabolism, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Disease, Shanghai Institute for Diabetes, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital.
authors: Fang
authors: F
authors: Liu
authors: Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology & Metabolism, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Disease, Shanghai Institute for Diabetes, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital.
authors: Weiping
authors: W
authors: Jia
mesh_terms: D000368:Aged; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D002681:China / Q000453:epidemiology; D055316:Cystatin C / Q000097:blood*; D017719:Diabetic Foot / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D014945:Wound Healing / Q000502:physiology
chemical_list: D015415:Biomarkers; D055316:Cystatin C