Neutrophil Extracellular Traps (NETs) Are Associated with Type 2 Diabetes and Diabetic Foot Ulcer Related Amputation: A Prospective Cohort Study

Introduction The prevalence of diabetes mellitus and its sequelae has been on the rise, and diabetic foot ulcer (DFU) is the leading cause of non-traumatic lower limb amputation globally. The rising occurrence and financial burden associated with DFU necessitate improved clinical assessment and treatment. Diabetes has been found to enhance the formation of neutrophil extracellular traps (NETs) by neutrophils, and excessive NETs have been implicated in tissue damage and impaired wound healing. However, there is as yet insufficient evidence to clarify the value of NETs in assessing and predicting outcomes of DFU. Methods We designed this prospective study with three cohorts formed from type 2 diabetes mellitus (T2DM) patients with DFU ( n = 200), newly diagnosed T2DM patients ( n = 42), and healthy donors ( n = 38). Serum levels of NETs were detected for all groups, and the prognostic value for DFU-related amputation was analyzed. Results The results showed that serum NET levels of the DFU group were significantly higher than in the T2DM group ( P