{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:11:31Z","timestamp":1788948691039,"version":"build-2803163510"},"reference-count":19,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Metabolites"],"abstract":"<jats:p>Objective: To determine whether systemic inflammation in peripheral artery disease is primarily associated with necrosis or a secondary response, we evaluated the association of tissue oxygenation (red blood cells), acute metabolic stress (admission glucose, albumin), systemic inflammation (C-reactive protein), and the red blood cell-to-albumin ratio. Materials and Methods: We retrospectively analyzed 375 patients undergoing endovascular interventions (58 with necrosis, 317 without). C-reactive protein-to-albumin and red blood cell-to-albumin ratios were calculated. Associations were assessed using parallel multivariate logistic regression models. Results: The necrosis group had significantly higher admission glucose and C-reactive protein-to-albumin ratio, but a lower red blood cell count and red blood cell-to-albumin ratio. In multivariate models of fundamental biomarkers, C-reactive protein lost independent significance; low red blood cells (Odds Ratio: 0.348, p = 0.0003) and elevated admission glucose (Odds Ratio: 1.008, p = 0.0018) were the strongest independently associated variables. In composite index models, the C-reactive protein-to-albumin ratio became a dominant associated factor, attenuating the red blood cell-to-albumin ratio\u2019s statistical significance. Conclusions: Anemia and admission hyperglycemia are strong correlates of tissue necrosis. Systemic inflammation appears to act as a secondary consequence of ischemic injury but profoundly exacerbates tissue loss when combined with nutritional depletion. Comprehensive medical management, including anemia correction and metabolic optimization, is fundamental for limb salvage.<\/jats:p>","DOI":"10.3390\/metabo16090662","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T09:24:02Z","timestamp":1788945842000},"page":"662","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anemia, Glycemia, and Inflammation in PAD-Related Tissue Necrosis"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9382-5179","authenticated-orcid":false,"given":"Mehmet","family":"Aslan","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Alanya Education and Research Hospital, 07400 Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.1016\/j.jvs.2006.12.037","article-title":"Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II)","volume":"45","author":"Norgren","year":"2007","journal-title":"J. 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