To investigate the levels and significance of bone alkaline phosphatase(BALP) and cross-linked N-telopeptides of type I collagen (NTX) in patients with diabetic foot osteomyelitis(DFO).

From October 2017 to June 2020, 139 patients with diabetic foot (DF) who were diagnosed and treated were selected as research objects. According to whether DF patients complicated with osteomyelitis, they were divided into non osteomyelitis group (n=59) and osteomyelitis group (n=80). The clinical data of the two groups were compared. The levels of serum BALP and NTX were detected by enzymelinked immunosorbent assay (ELISA), receiver operating characteristic curve (ROC) was used to evaluate the diagnostic value of serum BALP and NTX for DFO, and Multivariate Logistic regression analysis was used to analyze the influencing factors of DFO.

The glycosylated hemoglobin, WBC count, serum BALP and NTX levels in osteomyelitis group were significantly higher than those in non osteomyelitis group(P<0.05). There were no significant differences in age, male/female ratio, course of diabetes, proportions of diabetic nephropathy, proportions of ulcer history, proportions of coronary heart disease and proportions of hypertension (P>0.05); the area under the curve (AUC) of serum BALP and NTX in the diagnosis of DFO was 0.836 and 0.863, the cut-off value was 99.98 mmol/L and 9.45 nmol BCE/μM Cr, respectively, the corresponding sensitivity was 78.8%, 75.0% and the specificity was 84.3% and 88.1%, respectively. The AUC of combined diagnosis was 0.908, and the sensitivity and specificity were 91.3% and 83.1% respectively; WBC count, BALP and NTX were risk factors of DFO (P<0.05).

The levels of serum BALP and NTX in patients with DFO are significantly increased, and both of them may play an important role in the pathogenesis of DFO. BALP combined with NTX can improve the diagnostic value of DFO, which is helpful for clinical screening of DFO patients.