Evidence mapPaperPMID 40289101Full record

ArticleBMC endocrine disorders2025

Neutrophil-lymphocyte ratio (NLR); an accurate inflammatory marker to predict diabetic foot ulcer amputation: a matched case-control study.

Faeze Afshar, Morteza Daraie, Fatemeh Mohammadi, Kiana Seifouri, Samira Amin Afshari, Soheil Heidari Some'eh, Amirhossein Yadegar, Parnian Naghavi, Alireza Esteghamati, Soghra Rabizadeh and 3 more

Abstract read
In one paragraph

Article in BMC endocrine disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Faeze AfsharEndocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Morteza DaraieInternal Medicine Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Fatemeh MohammadiEndocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Kiana SeifouriEndocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Samira Amin AfshariEndocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Soheil Heidari Some'ehEndocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Amirhossein YadegarEndocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Parnian NaghaviEndocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Alireza EsteghamatiEndocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Soghra RabizadehEndocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mahsa AbbaszadehEndocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Manouchehr NakhjavaniEndocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Sahar Karimpour ReyhanEndocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran. skarimpour@sina.tums.ac.ir.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiabetic foot ulcer (DFU) is a well-known complication of diabetes. The main therapeutic options for treating DFU include surgical debridement. However, conditions such as sensory loss and insufficient blood supply can lead to lower extremity amputations. Inflammatory biomarkers, including the neutrophil‒lymphocyte ratio (NLR) and platelet‒lymphocyte ratio (PLR), have shown promise in predicting the development of diabetes complications.

methodsThis study included 126 individuals with known DFUs who underwent amputation or debridement surgery during hospitalization between January 2017 and December 2022. The participants were divided into two groups, each containing 63 patients, based on the treatment they received. Analyses were conducted via univariate and multivariate regression models. The linearity of the relationship between each inflammatory index and the risk of amputation was further examined via restricted cubic spline (RCS) curves with four knots.

resultsCategorical regression analysis showed an elevated risk of amputation in patients with an NLR greater than 6.08, with an OR of 13.090 (95% CI: 5.143-33.320, P < 0.001), compared with those with an NLR less than 6.08. Additionally, patients with a PLR greater than 210 demonstrated a similarly elevated risk of amputation with an OR of 2.31 (95% CI: 1.066‒4.669, P = 0.033); however, those with lymphocyte‒white blood cell ratio (LWR) levels of greater than 0.1265 exhibited reduced likelihood of having amputation (OR: 0.092 (95% CI: 0.038‒0.226, P < 0.001)).

conclusionsThis study supports that NLR, PLR and LWR may have value as a predictive marker for amputation in patients with DFUs.

Indexed as

Amputation, SurgicalDiabetic FootInflammationLymphocytesNeutrophilsAgedBiomarkersCase-Control StudiesFemaleFollow-Up StudiesHumansMaleMiddle AgedPredictive Value of TestsPrognosisBiomarkersDiabetic foot ulcerLymphocyte‒white blood cell ratioNeutrophil‒lymphocyte ratioPlatelet‒lymphocyte ratio

Identifiers

PMID40289101
PMCPMC12034133

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.