Investigation of ischemia-modified albumin levels and some atherosclerosis-related serum parameters in patients with diabetic foot

Abstract

IntroductionDiabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia, resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of DM is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels (1). Diabetic foot ulcers are estimated to affect 15% of all patients with DM during their lifetime (2). Ulceration, infection, gangrene, and lower extremity amputation are complications often encountered in patients with DM. These complications frequently result in extensive morbidity, repeated hospitalizations, and high treatment costs. The etiology of diabetic foot ulcers is multifactorial. Risk factors identified include peripheral neuropathy, vascular disease, limited joint mobility, foot deformities, abnormal foot pressures, minor trauma, a history of ulceration or amputation, and impaired visual acuity. Despite considerable international efforts, DM continues to be the most common underlying cause of nontraumatic lower extremity amputations in the United States and Europe (3).Background/aim: To investigate serum ischemia-modified albumin (IMA), oxidized low-density lipoprotein (ox-LDL) levels, and paraoxonase 1 (PON1) activity in patients with diabetic foot. Materials and methods:Thirty patients with diabetes mellitus (DM), 30 patients with diabetic foot (29 and 27 of these patients had type 2 DM, respectively), and 30 healthy volunteers as the control group were included in the study. The patients with diabetic foot were divided into 2 groups, as those who had or had not undergone lower extremity amputation. Serum PON1 activity, ox-LDL, and IMA levels were measured.Results: Serum PON1 activity was lower (P < 0.05) and ox-LDL levels were higher (P < 0.05) in the diabetic foot group than in the control and diabetes groups. Albumin-adjusted IMA values were higher (P < 0.001) in the diabetic foot group compared to the diabetes group. The postamputation levels of IMA were decreased compared to the preamputation condition (P < 0.05). Conclusion:The low activity of PON1 and the high levels of ox-LDL and IMA may play an important role in the pathogenesis of diabetic foot. The use of these parameters in the follow-up of patients with DM may prevent the development of diabetic foot. In order to reach a definitive judgment, further studies with a larger number of subjects are necessary.

Ischemia-modified albumin: Crosstalk between fatty acid and cobalt binding

“…It is therefore consistent with our hypothesis that those disease states are associated with positive ACB assays. Further conditions with positive ACB readings include diabetes [114] , hypothyroidism [115] , intrauterine growth restriction [116] , chronic inflammation (rheumatoid arthritis [117] and ankylosing spondylitis [118] ), infection (sepsis [119] and malaria [89] ), exercise [96] and trauma [97] . All of these are also associated with high FFA concentrations (see Table 2 ) through various physiological and pathophysiological pathways [120] , [121] , [122] , [123] , [124] , [125] .…”

Intralesional epidermal growth factor therapy fordiabetic foot ulcers: an evaluation of 15 cases

“…Diabetic foot ulcers represent one of the most common complications of diabetes and negatively affect patients' quality of life. Current estimates indicate that 15% of the entire diabetic patient population experiences diabetic foot ulcers at some point in their lives (1). This generates a significant burden in terms of healthcare costs.…”

Is Every Foot Wound a Diabetic Foot Infection in Diabetic Patients? A Case Of Kaposi Sarcoma

“…Among these causes, the incidences of diabetes and diabetes-related complications continue to increase [3] . Current data show that approximately 15% of the diabetic patient population has diabetic foot ulcers at some point in their lives [3,4] .…”