Background: Cellulitis of the foot contributes to morbidity in the diabetic population leading to considerable physical, physiological and financial burden not only for the patient but also for the community. Inflammatory markers like ESR and CRP, which are elevated, are non specific in identifying the severity of the disorder. We hypothesized that HDL which has a role in innate immunity can serve as a marker of severity. Methods: Retrospective analysis of laboratory investigations on the day of admission of sixty three patients of diabetes with cellulitis of the lower limbs was performed. Depending on the severity and treatment of the cellulitis the population were categorized into two groups. Group I (n=31) included those patients who needed only antibiotics and regular dressing for their healing. Those patients with severe cellulitis needing debridement and skin grafting for recovery were placed in Group II (n=32). Results: The prevalence and severity of cellulitis was more in males and also with duration of diabetes andpoor glycemic control. A significantly low HDL was seen in Group II, that had a negative correlation with recovery period (R2 -0.7, p<0.001). A HDL cut off value of 17mg/dl, (95% CI 0.815 - 0.967, SE-0.039) was used to calculate relative risk of morbidity which was 3.75 times higher (95% confidence interval 2.00-7.02, p<0.001). Conclusion: HDL in diabetic cellulitis may play a role in identifying the severity and hence can be used to change the modality of treatment thereby reducing morbidity.
