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  Zanko J Med Sci:  Dec. 2017; 21 (3): 1869-1877

Measurements of serum high sensitivity-C reactive protein, and procalcitonin levels in type1 and 2 Diabetes complicated with diabetic foot syndrome

Zhian M.I. Dezayee *, Marwan S.M. Al-Nimer **


* Departmentof Microbiology, College of Health Sciences, Hawler Medical University, Erbil, Iraq.

** Department of Pharmacology, College of Pharmacy, Hawler Medical University, Erbil, Iraq.


Background and objective: There is evidence that the procalcitonin levels are usually correlated with the high sensitivity C-reactive protein levels in inflammatory conditions. Therefore, this study aimed to assess the simultaneous changes of the procalcitonin and hs-CRP levels in the diabetic foot syndrome complicated type 1 and 2 diabetes.

Method: This observational study was carried in the Center of Diabetes Mellitus in Erbil, Iraq from 1st January to the 30th September 2015. A total number of 170 participants were enrolled in this study. They grouped into Group I (healthy subjects, n=30), Group II (type 1 diabetes with diabetic foot syndrome, n=70) and Group III (type 2 diabetes with diabetic foot syndrome, n=70). The anthropometric measurements, blood pressure, fasting serum glucose and lipid profile, and the inflammatory markers included high sensitivity C-reactive protein and procalcitonin were determined.

Results: Group III patients had a significant longer duration and score of diabetic foot syndrome, higher anthropometric measurements, higher blood pressure and fasting lipid profile levels compared with Group II. Serum procalcitonin and high sensitivity C-reactive protein levels were significantly higher in diabetic patients compared with Group I subjects. The serum levels of procalcitonin and high sensitivity C-reactive protein of Group III patients (1.11±0.47 ng/ml; 12.48±2.57 mg/L) were significantly higher than corresponding values of Group II patients (0.334±0.094 ng/ml; 5.73±0.89 mg/L). A non-significant correlation between procalcitonin with high sensitivity C-reactive protein in Group II and III was observed.

Conclusion: We conclude that the simultaneous measurements of high sensitivity C-reactive protein and procalcitonin as inflammatory biomarkers are not necessary because the correlation was not significant.

Keywords: Procalcitonin; High sensitivity C reactive protein; Diabetic foot syndrome.


1. Christ-Crain M, Muller B. Procalcitonin in bacterial infections--hype, hope, more or less? Swiss Med Wkly 2005; 135:451-60.

2. Uzun G, Solmazgul E, Curuksulu H, Turhan V, Ardic N, Top C, et al.Procalcitonin as a diagnostic aid in diabetic foot infections. Tohoku J Exp Med 2007; 213(4):305-12.

3. Meisner M. Update on procalcitonin measurements. Ann Lab Med 2014; 34(4): 263–73.

4. Bouadma L, Luyt CE, Tubach F, Cracco C, Alvarez A, Schwebel C, et al. Use of procalcitonin to reduce patients' exposure to antibiotics in intensive care units (PRORATA trial): a multicenter randomised control trial. Lancet 2010; 375(9713):463-74.

5. James WB. Classification of foot lesion in diabetic patients. In: Bowker JH, Pfeifer MA, eds, Levin and O’Neal’s The Diabetic Foot. 7th ed. Philadelphia: Mosby; 2008. P. 221-6.

6. Kocabaş ESarikçioğlu AAksaray NSeydaoğlu GSeyhun YYaman A. Role of procalcitonin, C-reactive protein, interleukin-6, interleukin-8 and tumor necrosis factor-alpha in the diagnosis of neonatal sepsis.Turk J Pediatr 2007; 49(1):7-20.

7. JonaidiJafari N, SafaeeFirouzabadi M, Izadi M, SafaeeFirouzabadi MS, Saburi A. Can procalcitonin be an accurate diagnostic marker for the classification of diabetic foot ulcers? Int J Endocrinol Metab 2014; 12(1):e13376.

8. Altay FASencan İŞentürk GÇ, Altay MGüvenman SÜnverdi Set al. Does treatment affect the levels of serum interleukin-6, interleukin-8 and procalcitonin in diabetic foot infection? A pilot study. J Diabetes Complications 2012; 26(3):214-8.

9. Wang C, Gao L, Zhang ZG, Li YQ, Yang YL, Chang T, et al. Procalcitonin is a stronger predictor of long-term functional outcome and mortality than high-sensitivity C-reactive protein in patients with ischemic stroke. Mol Neurobiol 2016; 53(30):1509-17.

10. Li YM, Liu XY. Serum levels of procalcitonin and high sensitivity C-reactive protein are associated with long-term mortality in acute ischemic stroke. J Neurol Sci 2015; 352(1-2):68-73.

11. Villanueva MP, Mollar A, Palau P, Carratalá A, Núñez E, Santas E, et al. Procalcitonin and long-term prognosis after an admission for acute heart failure. Eur J Intern Med 2015; 26(1):42-8.

12. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972; 18:499-502.

13. Boursier G, Avignon A, Kuster N, Boegner C, Leprieur E, Picandet M, et al. Procalcitonin, an Independent Marker of Abdominal Fat Accumulation in Obese Patients. Clin La 2016; 62:435-41.

14. Massara M, De Caridi G, Serra R, Barillà D, Cutrupi A, Volpe A, et al. The role of procalcitonin as a marker of diabetic foot ulcer infection. Int Wound J 2017; 14(1):31-4.

15. Mutluoğlu M, Uzun G, İpcioğlu OM, Sildiroglu O, Özcan Ö, Turhan V, et al. Can procalcitonin predict bone infection in people with diabetes with infected foot ulcers? A pilot study.Diabetes Res Clin Pract 2011; 94(1):53-6.

16. Mica L, Vomela J, Keel M, Trentz O. The impact of body mass index on the development of systemic inflammatory response syndrome and sepsis in patients with polytrauma. Injury 2014; 45(1):253-8.

17. Abbasi A, Corpeleijn E, Postmus D, Gansevoort RT, de Jong PE, Gans RO, et al. Plasma procalcitonin is associated with obesity, insulin resistance, and the metabolic syndrome. J Clin Endocrinol Metab 2010; 95(9):E26-31.

18. Mallamaci F, Leonardis D, Pizzini P, Cutrupi S, Tripepi G, Zoccali C. Procalcitonin and the inflammatory response to salt in essential hypertension: a randomized cross-over clinical trial. J Hypertens 2013; 31(7):1424-30.

19. van Leeuwen HJ, Heezius EC, Dallinga GM, van Strijp JA, Verhoef J, van Kessel KP. Lipoprotein metabolism in patients with severe sepsis. Crit Care Med 2003; 31(5):1359-66.

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