Diagnostic Value of Neutrophil CD64 Index in Diabetic Foot Osteomyelitis
Authors:
- Haojie SunHSHaojie Sun
- Hao HengHHHao Heng
- Xuekui LiuXLXuekui Liu
- Houfa GengHGHoufa Geng
- Jun LiangJLJun Liang
Open Access
- 1 August 2025
- journal article
- research article
- Published by Taylor & Francis in Diabetes, Metabolic Syndrome and Obesity
- Vol. ume 18, 2985-2994
Abstract
Objective: This study aims to assess the value of the Neutrophil CD64 (nCD64) index as a novel, rapid biomarker for the diagnosis of Diabetic foot osteomyelitis (DFO), with the goal of enhancing the accuracy of early detection. Methods: A total of 142 hospitalized patients with type 2 diabetes complicated by diabetic foot infection were included. Participants were categorized into a Non-DFO group (84 cases) and a DFO group (58 cases) based on the presence or absence of osteomyelitis. The white blood cell count (WBC), C-reactive protein (CRP), and procalcitonin (PCT), erythrocyte sedimentation rate (ESR), and the nCD64 index were compared between the two groups. Logistic regression analysis was performed to identify risk factors associated with DFO. Receiver operating characteristic (ROC) curves were generated, and the area under the curve (AUC) was calculated to evaluate the sensitivity and specificity of the nCD64 index in diagnosing DFO. Results: The nCD64 index was significantly elevated in the DFO group compared to the Non-DFO group (P< 0.05). Logistic regression analysis indicated that the nCD64 index and ESR were independent risk factors for DFO (P < 0.05). The ROC-AUC analysis indicated that both the nCD64 index and ESR were associated with DFO. The nCD64 index exhibited superior predictive value compared to ESR (AUC: 0.895 vs 0.846). Specifically, the nCD64 index demonstrated the highest sensitivity at 96.6%, while ESR showed the highest specificity at 82.1%. When combined, the predictive value of the nCD64 index and ESR was optimal, with an AUC of 0.937, sensitivity of 86.2%, and specificity of 91.7%. Conclusion: The nCD64 index may serve as an effective new biomarker for the early detection of DFO. The combination of the nCD64 index and ESR could further enhance diagnostic accuracy.Keywords
This publication has 51 references indexed in Scilit:
- Bidirectional two-sample Mendelian randomization study of differential white blood cell counts and schizophreniaBrain, Behavior, and Immunity, 2024
- Diagnosis of infection in the foot of patients with diabetes: A systematic reviewDiabetes/Metabolism Research and Reviews, 2023
- Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update)Diabetes/Metabolism Research and Reviews, 2020
- Diagnostic and therapeutic update on diabetic foot osteomyelitisEndocrinología, Diabetes y Nutrición (English Ed.), 2017
- Osteomielitis de pie diabético: ¿es posible un manejo conservador?Enfermedades Infecciosas y Microbiología Clínica, 2014
- Inter-observer reproducibility of diagnosis of diabetic foot osteomyelitis based on a combination of probe-to-bone test and simple radiographyDiabetes Research and Clinical Practice, 2014
- Neutrophil CD64 expression as a biomarker in the early diagnosis of bacterial infection: a meta-analysisInternational Journal of Infectious Diseases, 2013
- Can procalcitonin predict bone infection in people with diabetes with infected foot ulcers? A pilot studyDiabetes Research and Clinical Practice, 2011
- Neutrophil CD64 expression as marker of bacterial infection: A systematic review and meta-analysisJournal of Infection, 2010
- Comparison of WBC, ESR, CRP and PCT serum levels in septic and non-septic burn casesBurns, 2008