The role of biomarkers to diagnose diabetic foot osteomyelitis. A meta-analysis

Suzanne Aura Victoria Van Asten, Edgar Joseph Geradus Peters, Yin Xi, Lawrence Alfred Lavery

Research output: Contribution to journalReview articlepeer-review

33 Scopus citations


Purpose: To systematically review the value of serum inflammatory markers to diagnose diabetic foot osteomyelitis (DFO). Study selection: Studies to diagnose DFO using biomarkers erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT), interleukins (IL-2, IL-6, IL-8) and tumor necrosis factor alfa (TNFα) were retrieved from EMBASE and PubMed with no language restrictions through July 2014. Data extraction: We summarized clinical characteristics of the studies and used bivariate random effects models and summary receiver operating characteristic curves to estimate sensitivity and specificity for each marker. Data synthesis: A total of 8 qualifying studies were included in our meta-analysis. Bivariate pooled sensitivity and specificity of the 6 studies examining ESR were 0.81 (95% CI 0.71-0.88) and 0.90 (95% CI 0.75-0.96) respectively. Due to the paucity of data, models did not converge for the other biomarkers. Conclusions: From the inflammatory markers, ESR appears to be the best laboratory test to identify patients with DFO.

Original languageEnglish (US)
Pages (from-to)396-402
Number of pages7
JournalCurrent Diabetes Reviews
Issue number4
StatePublished - Dec 1 2016


  • Biomarkers
  • C-reactive protein
  • Diabetic foot
  • Diabetic foot infection
  • Diagnosis
  • Erythrocyte sedimentation rate
  • Osteomyelitis
  • Procalcitonin

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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