Association of Antioxidant, Inflammatory, and Glycemic Status in Patients with Diabetic Foot Ulcers in Karachi, Pakistan: A Comparative Cross-Sectional Study

Authors

Abstract

Objective: To evaluate the association of antioxidant, inflammatory, and glycemic status in Patients with diabetic foot ulcers in Karachi, Pakistan.

Methods

A comparative cross-sectional study was conducted at the Department of Physiology in collaboration with the Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, from June 2023 to June 2024. A total of 138 participants were enrolled and grouped into healthy controls, type 2 diabetics, and type 2 diabetics with foot ulcers. Type 1 diabetic patients were excluded. Glycemic parameters, including fasting blood glucose (FBG) and glycated hemoglobin (HbA1c), the oxidative stress marker superoxide dismutase (SOD), inflammatory biomarkers, including C-reactive protein (CRP), complete blood count parameters, and the neutrophil-to-lymphocyte ratio (NLR) were assessed. SOD was measured by ELISA, HbA1c by HPLC, and CRP by immunoturbidimetry. Statistical analysis was performed using IBM SPSS version 23.0.

Results

 Median FBG, HbA1c, SOD, CRP, TLC, neutrophil percentage, lymphocyte percentage, and NLR differed significantly among the three groups by applying the Kruskal–Wallis test, and Dunnett's T3 post hoc analysis showed a significant difference (p < 0.001) in SOD levels among the three groups. HbA1c (OR=89.0; 95% CI:11.6–680), CRP (OR=1.08; 95% CI:1.02–1.13), and NLR (OR=1.86; 95% CI:1.28–2.71) were significant risk factors for DFU, whereas higher SOD levels (OR=0.87; 95% CI:0.84–0.91) showed a protective association by Multinomial logistic regression.

Conclusion

 Poor glycemic control, increased systemic inflammation, and reduced antioxidant defense in DFU patients play a critical role in the development of foot ulcers in diabetic patients.

Keywords:

C-reactive protein, diabetes mellitus, fasting blood sugar, foot ulcer, and superoxide dismutase.

Published

2026/08/21

Issue

Vol. Volume 7-issue 3

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