Correlation Analysis Of Serum HMGB1 And CysC With Diabetic Foot

Objectives To investigate the relationship between the Serum High Mobility Group Box 1(HMGB1),Cystatin C(CysC)l levels and Diabetic Foot(DF).Methods Selecting 156 patients with type 2 diabetes as subjects,these patients are hospitalized in the Endocrinology Department of Kailuan General Hospital from January 2016 to October 2017.According to if the Diabetic Foot is combined,they were divided into Diabetic Foot group(DF group,n=80)and simple Diabetes Mellitus group(DM group,n=76).The DF group was divided into Ischemic Diabetic Foot group(IDF group,n=51)and Non-Ischemic Diabetic Foot group(NIDF group,n=29)according to whether there was ischemia in the foot.All subjects’ situations like gender,age,history of diabetes,smoking and alcohol consumption ect.were recorded in detail;the height,weight,SBP and DBP of all subjects was measured and recorded in detail;the biochemical,blood glucose,blood lipid and other clinical indicators of all subjects were measured and recorded accurately.The serum HMGB1 and CysC concentrations was measured by double antibody sandwich method.Patients in the DF group were grouped according to the Wagner 1~5 grading standard.High HMGB1 and CysC concentrations were used as exposure factors to investigate the association of serum HMGB1 and CysC concentrations with diabetic foot disease and ischaemic diabetic foot disease.All data were analyzed using SPSS20.0 software.Results 1 Comparison between DF group and DM group: Compared with the DM group,the DF Group patients’ levels in BMI,HbA1 c,2h-PG,FPG,HMGB1 and CysC were higher than the DM group(P<0.05),the difference was statistically significant.DF group patients’ levels of total bilirubin were lower than those in the DM group(P<0.05),the difference was statistically significant.Using the concentration of serum HMGB1≥170.07μg/L as an exposure factor and calculating the relationship between HMGB1 and Diabetic Foot disease using a four-cell table,the results showed that OR=4.024,which indicated that when the Diabetic Foot disease patients’ serum HMGB1 was above exposure concentration,the risk of diabetic foot disease was 4.024 times as high as that of patients with non diabetic foot disease.Using the concentration of serum CysC≥1036.47μg/L as an exposure factor and calculating the relationship between CysC and diabetic foot disease by using a four-cell table,the results showed that OR=1.955,which indicated that when diabetic patients’ serum CysC reached above the exposure concentration,the risk of diabetic foot disease was 1.955 times as high as that of non diabetic foot disease patients.Multivariate logistic regression analysis of diabetic foot disease revealed that total bilirubin was a protective factor for diabetic foot disease;duration,2h-PG,HMGB1,and CysC were risk factors for diabetic foot disease.2 Comparison between IDF and NIDF groups: Compared with NIDF group,the IDF Group patients’ level in HbA1 c,HMGB1and CysC were higher than the NIDF group(P<0.05),the difference was statistically significant;the IDF Group patients’ level of total bilirubin c was lower than the NIDF group(P<0.05),the difference was statistically significant.Adopting the concentration of serum HMGB1 ≥ 188.31μg/L as an exposure factor and calculating the relationship between HMGB1 and ischaemic diabetic foot disease by using a four-cell table,the results showed that OR=3.987,which indicated that when the Diabetic Foot disease patients’ serum HMGB1 was above exposure concentration,the risk of ischemic diabetic foot disease was 3.987 times as high as that of patients with non ischemic diabetic foot disease.Adopting the concentration of serum CysC≥1088.38μg/L as an exposure factor and calculating the relationship between CysC and ischaemic diabetic foot disease by using a four-cell table.the results showed that OR=2.536,which indicated that when the patients’ Serum CysC with diabetic foot disease was above exposure concentration,the risk of ischemic diabetic foot disease is 2.536 times as high as that of patients with non ischemic diabetic foot disease.Multivariate Logistic regression analysis of ischemic diabetic foot disease revealed that total bilirubin is a protective factor for ischemic diabetic foot disease;HbA1c,HMGB1,and CysC are risk factors for ischemic diabetic foot disease.Conclusions 1 Serum HMGB1 and CysC levels in diabetic patients are positively correlated with the risk of diabetic foot disease.When serum HMGB1 and CysC levels are elevated,the risk of diabetic foot disease is increased.2 Serum HMGB1 and CysC levels in patients with diabetic foot disease are positively correlated with the risk of ischemic diabetic foot disease.When serum HMGB1 and CysC levels are elevated,the risk of developing ischemic diabetic foot disease is increased.