Is There an Association between Amputation Risk and Nutritional Status in Diabetic Foot Syndrome?

Diabetic foot syndrome (DFS) occurs in 15-25% of diabetic patients. Identification of risk factors for malnutrition and prevention is valuable for patients with DFS. The aim of this study was to investigate the association between blood parameters and nutritional indices obtained from simple blood parameters and diabetic foot amputations.

A single-center cross-sectional observational study was conducted between March 2024 and March 2025. According to whether they underwent amputation, including amputations of minor and major lower extremities, patients were divided into two groups: amputated (Group A) and non-amputated (Group NA). Patients older than 18 years with a DFD diagnosis were included. Data was analyzed statistically.

A total of 237 DFS patients were included in the study, with 92 patients in Group A and 145 patients in Group NA. CRP/albumin ratio (p < 0.001), albumin/globulin ratio (p = 0.003), PNI (p < 0.001), and CONUT score (p < 0.001) results revealed statistically significant differences between groups. CONUT score demonstrated significant associations in univariate and multivariate analyses. Patients with a CONUT score ≥ 5 had a 2.28 times higher risk of amputation compared to patients with a CONUT score < 5.

Our results showed significant correlations between CONUT score and amputation as well as a significant association between both CONUT scores and CONUT severity, and diabetic foot amputations. This study also demonstrates that the CONUT score is a significant predictor of amputation risk in patients with diabetic foot disease, with those having a CONUT score ≥ 5 showing a 2.28-fold increased risk of amputation.