| dc.description.abstract | Introduction. Diabetes mellitus (DM) is a chronic disease with increasing prevalence and
frequent complications in the form of diabetic ulcers, which contribute to high amputation
and mortality rates. Diabetic ulcers occur due to vascular and neuropathy disorders in DM
patients. Assessing ulcer severity using inflammatory biomarkers such as CRP, ESR, and
NLR is considered important clinically, but evidence in local populations is still limited.
Therefore, this study evaluated the association between CRP, ESR, and NLR with diabetic
ulcer severity in DM patients.
Methods. This study was an observational analytical study with a cross-sectional design
involving patients with type 2 diabetes mellitus with diabetic ulcers at Haji Adam Malik
General Hospital, Medan. Samples were obtained through consecutive sampling technique
with a minimum of 80 subjects who met the inclusion criteria and were not included in the
exclusion criteria. Clinical and laboratory data were analyzed using parametric and nonparametric statistical tests according to the data distribution, with a significance level of
p<0.05. The relationship between inflammatory biomarkers and ulcer severity was
evaluated using correlation and regression analysis to determine the most influential
variables.
Results. The majority of the study sample was 56.5 years old, male, and had an overweight
BMI. CRP, NLR, and ESR values were found to be significantly associated with ulcer
severity (p<0.05). Multivariate analysis found a significant correlation between CRP and
NLR with the severity of diabetic ulcers (p<0.001). There was a non-significant association
between ESR values and diabetic ulcer severity (p=0.309).
Discussion. CRP, ESR, and NLR were evaluated as inflammatory biomarkers with clinical
relevance in assessing the severity of diabetic foot ulcers due to their elevation in diabetesrelated inflammation. CRP and NLR demonstrated greater accuracy in predicting ulcer
severity and the risk of complications, while ESR was used as a supporting indicator,
particularly in cases of suspected infection or osteomyelitis.
Conclusion. CRP, NLR, and ESR can be used as markers of diabetic ulcer severity and
have a significant correlation with diabetic ulcer severity, although the correlation with
ESR is weak.
Keywords: Diabetic Ulcer, CRP, NLR, ESR, and Wagner Criteria | en_US |
