Association between inflammatory markers and anemia in patients with diabetic foot ulcer

Aim: Anemia of inflammation (AI) is common among patients with diabetic foot ulcers (DFU). This study aimed to investigate the specific relationship between inflammation indicators and anemia in patients with DFU.Materials & methods: This cross-sectional study was carried out among patients with DFU between 2018 and 2023. Clinical data were gathered before treatment. Restricted cubic spline regression was employed to investigate the non-linear associations between inflammation and anemia.Results: A total of 395 patients with Wagner grades 2-4 were enrolled in the study. About 63.54% of the patients with DFU had anemia which was primarily presented with normocytic hypopigmentation anemia. Elevated IL-6 levels (39.10-369 pg/ml) were significantly associated with an increased likelihood of anemia (OR = 4.84; 95% CI: 1.97-11.90). Similarly, high CRP levels (48.56-385 mg/l) were linked to a higher prevalence of anemia (OR = 5.01; 95% CI: 2.35-10.68). Furthermore, a nonlinear relationship was observed between CRP levels and anemia, suggesting that CRP values exceeding 53.889 mg/l may trigger anemia in patients with diabetic foot ulcers.Conclusion: Inflammation is identified as an independent risk factor for AI in patients with DFU. The inflammation indicators (CRP and IL-6) and anemia exhibit an L-shaped nonlinear correlation in patients with DFU.