The Erythrocyte Sedimentation Rate is a Simple, Sensitive and Predictive Hematological Index for Non-Septic Diabetic Foot Syndrome: A Cross-Sectional Study

OBJECTIVE: Several studies have found that the hematological index can be considered as a prognostic biomarker of diabetes mellitus. This study aimed to compare the level of the erythrocyte sedimentation rate (ESR) with other hematological indices as a predictive marker of non-infected diabetic foot syndrome (DFS). MATERIALS AND METHODS: A total of 137 patients with diabetes (53 males and 84 females) and another 30 healthy subjects (10 males and 20 females) were included in this study. The participants were grouped into Group I (healthy subjects, n = 30); Group II (n = 72, type 2 diabetes without clinical evidence of DFS features); and Group III (n = 65, type 2 diabetes with clinical evidence of DFS features (grade 0–2). Hematological indices were determined by a hematology autoanalyzer. RESULTS: The serum fasting glucose levels were significantly higher among Group III patients compared with Groups I and II. The value of ESR was significantly higher among Group III patients compared with Group II. The ESR and red distribution width (RDW) values increased in tandem with the DFS upgrade. The area under the curve (AUC) of the ESR at a cutoff value of 18 mm/hour was 0.663 with 95% confidence intervals of 0.571–0.755, which was significantly (p < 0.001) higher than the AUC of RDW, platelet distribution width, mean platelet volume, and plateletcrit. Also, the area under the curve of the ESR increased as the upgrading of DFS increased. CONCLUSIONS: We conclude that determination of ESR serves as a predictor and discriminator of DFS and its upgrading.