Sustained elevation of the proinflammatory cytokine IL-6 but not CRP in serum of type 2 diabetes patients with diabetic foot syndrome

Rose, Beate G.; Shin, Dongyun; Friese, G.; Othman, Talat; Poschen, U.; Herder, Christian; Scherbaum, Werner A.; Köenig, Wolfgang; Martin, Stéphan

doi:10.1055/s-2006-933075

Cited by 1 publication

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“…Estudos clínicos preliminares revelam concentrações de marcadores inflamatórios (IL-6 e PCR) marcadamente elevadas em quadros agudos de úlcera de indivíduos diabéticos (29,30), havendo relação direta destes marcadores com a extensão da lesão e a gravidade da infecção. Particularmente em indivíduos neuropatas, não está documentada associação destes marcadores com risco de úlcera.…”

Section: Discussionunclassified

“…O ITB, validado pela angiografia contrastada, apresenta alta sensibilidade e especificidade para detectar estenoses ≥ 50%, sendo recomendado pela comunidade científica para fins diagnósticos (14). Porém, diante de artérias não-compressíveis em membros inferiores -como ocorre mais freqüentemente em pacientes diabéticos ou idosos devido à calcificação da parede arterial -, o ITB pode fornecer resultados não-interpretáveis (14,29). Isso de fato ocorreu com 5 indivíduos da nossa amostra, que apresentaram ITB > 1,30.…”

Section: Discussionunclassified

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Análise de fatores associados à ulceração de extremidades em indivíduos diabéticos com neuropatia periférica

Porciúncula

Rolim

Garofolo

et al. 2007

Arq Bras Endocrinol Metab

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Analysis of Factors Associated with Extremity Ulceration in Diabetic Subjects with Peripheral Neuropathy.Peripheral neuropathy is the main risk factor for foot ulceration in diabetic subjects. This study examined the association of peripheral arterial disease (PAD) with foot ulceration in a sample of diabetic subjects with peripheral neuropathy, and also if inflammatory markers would be associated with this event. We evaluated 32 type 2 diabetic individuals with abnormal 10-g monofilament exam, who were stratified in 2 groups according to history or presence of lower extremities ulcer. The group "with ulcer" (n = 18) included the ones that had active or cicatrized ulcer, or some lower-extremity amputation due to ulcer complications. In addition to the neurological examination and monofilament test, they were submitted to biothesiometry, lower extremity vascular assessment with Doppler, and laboratory determinations. No difference between the groups was found concerning sex distribution, mean age, and duration of diabetes diagnosis. The group with ulcer showed higher mean values of height (1.70 ± 0.06 vs. 1.63 ± 0.11 m, p = 0.044), vibration perception threshold measured in medial malleolli (40.9 ± 13.0 vs. 30.6 ± 12.3 V, p = 0.040) than the group without ulcer. The groups did not differ regarding the mean values of the inflammatory markers. Response to patellae reflex was worse in the group with ulcer (p = 0.047), in which a higher proportion of individuals with abnormal toe-brachial index (p = 0.030) was observed as compared to those without ulcer. We concluded that PAD is associated with the presence of ulcer in neuropathic subjects. The assessment of digital arteries flow in lower limbs (in great toe) contributed to detect such association. Association of diabetic foot ulcers and inflammatory markers was not observed, but cannot be excluded due to limitations of sample size. Prospective studies should examine the sensitivity of the toe-brachial index to identify PAD in diabetic individual at risk of ulceration.

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Section: Discussionunclassified