Cross-sectional study reveals elevated Netrin-1 distinguishes diabetic foot ulcers from uncomplicated diabetes, suggesting its utility as a diagnostic circulatory biomarker.
AimTo measure serum levels of Pentraxin-3 (PTX-3) and Netrin-1 in diabetic patients with and without foot ulcers and determine how these levels relate to clinical features, glycemic control, and ulcer status.MethodsIn this cross-sectional study, 80 patients were divided into three groups: infected diabetic foot ulcer (IDFU, n = 27), non-infected diabetic foot ulcer (NIDFU, n = 27), and diabetes control (n = 26). Biochemical, demographic, and clinical data were gathered. PTX-3 and Netrin-1 levels in serum were measured using ELISA. ANOVA, regression, and correlation analyses were used to assess biomarker relationships and group comparisons.ResultsAcross all groups, there was a significant increase in fasting blood glucose, HbA1c, and diabetes duration. There was no significant difference in PTX-3 levels. Netrin-1 levels were linked with HbA1c (r = 0.37) and fasting blood glucose (r = 0.41) and were higher in both ulcer groups (p < 0.001). While PTX3 performed poorly (AUC = 0.518-0.576), Netrin-1 exhibited good diagnostic accuracy for differentiating IDFU and NIDFU from DM (AUC = 0.891 and 0.855, respectively). Netrin-1 did not, however, distinguish infected from non-infected ulcers (AUC = 0.510).ConclusionElevated serum Netrin-1 levels and their positive association with glycemic indices suggest a potential role for Netrin-1 in diabetic foot ulceration, whereas PTX-3 showed no significant associations.
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Yadav et al. (2026) studied this question.
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