Platelet-to-Lymphocyte Ratio in Diabetic Patients with Foot Ulcers and without Foot Ulcers

Abstract

Introduction: Diabetes mellitus (DM) is a widespread chronic disease, often leading to complications like diabetic foot ulcers (DFU), which can result in infections, osteomyelitis, or amputations. The platelet-to-lymphocyte ratio (PLR), an inflammatory marker, may predict adverse outcomes in various conditions. This study investigates the relationship between PLR and DFU severity in type 2 diabetes mellitus (T2DM) patients, focusing on its potential to predict ulcer severity and patient outcomes.

Objective: The primary objective of this study was to assess the association between PLR and diabetic foot ulcers in T2DM patients, and to evaluate PLR as a prognostic marker for outcomes such as wound severity, re-amputation, and mortality.

Methods: This hospital-based, prospective observational study included 118 participants, divided into two groups: 59 patients with DFU and 59 controls without DFU. Peripheral venous blood samples were collected to measure PLR, and HbA1c levels were recorded for glycemic control assessment. Data were analyzed using multivariate logistic regression to determine the relationship between PLR and DFU severity based on Wagner's classification.

Results: The mean PLR was significantly higher in patients with DFU (192.14 ± 95.77) compared to controls (144.15 ± 75.25), p < 0.001. HbA1c levels were also elevated in the DFU group (10.03 ± 2.19 vs. 8.06 ± 2.14, p < 0.001). PLR was positively correlated with Wagner’s DFU grade (p = 0.038), indicating its potential as a marker for assessing ulcer severity.

Conclusion: PLR is a simple, cost-effective marker that could help predict the severity of diabetic foot ulcers and identify patients at higher risk of adverse outcomes. Its inclusion in routine diagnostic workups may improve the early detection and management of diabetic complications.