{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T19:24:24Z","timestamp":1769628264195,"version":"3.49.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetic foot ulcer (DFU) is one of the serious complications of type 2 diabetes (T2DM). Malnutrition is associated with amputation in DFU patients. We aimed to use the CONUT score to investigate the risk factors associated with DFU amputation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 387 DFU patients admitted to the First Affiliated Hospital of Guangxi Medical University from January 2024 to June 2025. The patients were divided into non-amputation group (n=231) and amputation group (n=156). Additionally, patients were divided into three groups based on the CONUT score. Demographic characteristics, blood biochemical indicators, amputation rate were measured. Multiple linear regression analysis, multivariate binary logistic regression analysis, subgroup analysis and receiver operating characteristic (ROC) curve analysis were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall amputation rate of DFU patients was 40.3%. The amputation group had longer hospital stays, larger foot ulcer areas, higher incidence of osteomyelitis and peripheral arterial disease (PAD) than those without amputation. In addition, the amputees had lower levels of albumin, prealbumin, hemoglobin and prognostic nutritional index, but higher levels of WBC, ESR, and CONUT score. As the CONUT score increased, the amputation rate of patients also increased. Logistic regression found that CONUT score, osteomyelitis and PAD were independent risk factors of amputation in DFU patients. Subgroups analysis showed CONUT score remained significantly associated with DFU amputation in the subgroups except in patients with HbA1c &amp;lt; 7%. ROC analysis showed that the AUC was 0.705 (95% CI: 0.652\u20130.758, p&amp;lt;0.001), indicating that CONUT score had good predictive performance for DFU amputation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CONUT score was associated with amputation in DFU patients. Early assessment of the patient\u2019s nutritional status and improvement of malnutrition can reduce the risk of amputation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1690617","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T06:45:43Z","timestamp":1769582743000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between controlling nutritional status (CONUT) score and amputation risk factors in T2DM patients with DFU"],"prefix":"10.3389","volume":"17","author":[{"given":"Jie","family":"Xiang","sequence":"first","affiliation":[{"name":"Department of Clinical Nutrition, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weijia","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Health Management, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Bone and Joint Surgery, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanhui","family":"Tu","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongsheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(24)00250-0","article-title":"Diabetes in China part 1: epidemiology and risk factors","volume":"9","author":"Xu","year":"2024","journal-title":"Lancet Public Health"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2016.1231932","article-title":"Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis \u2020","volume":"49","author":"Zhang","year":"2017","journal-title":"Ann Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1093\/cid\/ciad255","article-title":"Evaluation and management of diabetes-related foot infections","volume":"77","author":"Cortes-Penfield","year":"2023","journal-title":"Clin Infect Dis Off Publ Infect Dis Soc Am"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.14296","article-title":"Risk factor analysis for diabetic foot ulcer-related amputation including Controlling Nutritional Status score and neutrophil-to-lymphocyte ratio","volume":"20","author":"Zhu","year":"2023","journal-title":"Int Wound J"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2018.10.097","article-title":"Quantifying the costs and profitability of care for diabetic foot ulcers treated in a multidisciplinary setting","volume":"70","author":"Hicks","year":"2019","journal-title":"J Vasc Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1038\/s41387-024-00290-6","article-title":"Risk factors for malnutrition in patients with diabetic foot ulcer and its association with prolonged length of hospitalization","volume":"14","author":"Ran","year":"2024","journal-title":"Nutr Diabetes"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1144806","article-title":"Clinical characteristics and risk factors of lower extremity amputation in the diabetic inpatients with foot ulcers","volume":"14","author":"Gong","year":"2023","journal-title":"Front Endocrinol"},{"key":"B8","article-title":"CONUT: a tool for controlling nutritional status. 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