Relationship between the atherogenic index of plasma and minor amputation of diabetic foot

Objective To explore the relationship between atherogenic index of plasma (AIP) and the occurrence of minor amputations (below ankle joint) in patients with diabetic foot ulcers. Methods A retrospective cross-sectional research was used to select 207 patients with type 2 diabetic foot ulcers who were hospitalized in the Endocrinology Department of Taiyuan Central Hospital between January 2020 and June 2022. Based on whether the patients underwent a minor amputation, the patients were divided into a non-amputation group (n =107) and a minor amputation group (n =100). Baseline data and AIP levels were collected and compared between the two groups. The relationship between AIP and minor amputation in diabetic foot was studied using univariate and multivariate logistic regression analysis. The diagnostic value of AIP and its combined indicators for minor amputation in diabetic foot was analyzed using the receiver operating characteristic (ROC) curve. Results The level of AIP in the minor amputation group was significantly lower than that in the non-amputation group ［0.11 (-0.04, 0.26) vs 0.16 (0.08, 0.32), Z=2.940, P=0.003］. Multivariate logistic regression analysis showed that high fibrinogen, peripheral vascular disease, drinking history, gangrene, long hospital stay, and multiple hospitalizations were risk factors for minor amputation in patients with diabetic foot (P＜0.05), whereas high levels of body mass index, fasting blood glucose, total cholesterol, and AIP were protective factors (P＜0.05). ROC curve analysis showed that the area under the ROC curve (AUC) for AIP alone predicting minor amputation was 0.618, with a sensitivity of 74.8%, specificity of 44.0%, and the optimal cut-off value of 0.08. The AUC for AIP combined with total cholesterol, fasting blood glucose, drinking history, gangrene, hospitalization times and length of stay was 0.900, with a sensitivity of 86.0%, specificity of 79.0%. Conclusion A decrease in AIP levels is associated with an increased risk of minor amputation in patients with diabetic foot ulcers.