2731-LB: Vitamin D and the Ratio of C-reactive Protein to High Density Lipoprotein Cholesterol in Relation to Risk of Diabetic Foot Ulcers

Introduction and Objective: The purpose of this study was to investigate the joint predictive value of vitamin D and the ratio of C-reactive protein to high density lipoprotein cholesterol (CHR) on the risk of diabetic foot ulcer (DFU). Methods: We enrolled 4350 hospitalized patients (2051 men and 2299 women aged 30 to 89 yrs) with T2D. Vitamin D deficiency (VDD) and vitamin D insufficiency (VDI) were defined as serum 25(OH)D level < 20 ng/mL and of 20-29.9 ng/mL, respectively. DFU was diagnosed according to IWGDF 2019 guideline. Logistic regression model and ROC curves analysis were applied to clarify the relationship between vitamin D, CHR and risk of DFU. Results: The serum level of 25(OH)D in the DFU group was significantly lower than that in the Non-DFU group (13.75 v.s. 20.24 ng/ml, P<0.001). Serum 25(OH)D levels were negatively correlated with ESR, CRP, CHR, NE%, WBC, TG, and HbA1c (all P<0.05), but positively correlated with ALB, TP, and HDL-C (P<0.05). CHR and duration of diabetes were independent risk factors while serum 25(OH)D and albumin concentrations were independent protective factors for DFU after multiple adjustment (P<0.05). The AUC of serum 25(OH)D in predicting DFU was 0.73 (95% CI: 0.69-0.76, P<0.001), with the sensitivity of 55.6% and the specificity of 81.3%. The corresponding figure for CHR was 0.80 (95% CI: 0.76-0.83, P<0.001), with the sensitivity of 60.4% and the specificity of 88.5%. The AUC of the joint effect of 25(OH)D and CHR was 0.86 (95% CI: 0.83-0.88, P<0.001), with the sensitivity of 75.6% and the specificity of 83.0%. Conclusion: Serum vitamin D level has potential predictive value for the early identification and diagnosis of DFU. The synergy use of vitamin D with other risk factors such as CHR may further improve the predicting value. Disclosure M. Wang: None. Y. Ding: None. J. Yao: None. G. Guo: None. L. Zhang: None.