| Insulin-like growth factor 1 correlate with diabetic foot ulcers in type 2 diabetic foot patientsAims Research on diabetic foot ulcer patients serum insulin-like growth factor 1(IGF-1) level of change and different degree of ulcer of skin tissue in the expression of IGF 1, and its influence on diabetic foot ulcers.Methods We included 74 cases of diabetic foot(DF group, age 60 years ± 11 years, diabetic duration 155 months ± 84 months, including Wagner grade 1-2, grade 3 and grade 4), and 81 case of Diabeties mellitus(DM group, age/duration matched DF group, as a control), hospitalized during the same period. Serum levels of IGF-1 as well as clinical and biochemical indicators were measured and compared between the two groups. The impact of serum IGF-1 on diabetic foot ulcers was analyzed. Return of 15 cases of diabetic foot patients foot painless ulcer of skin(age 60 years ± 5 years, diabetic duration 150 months ± 54 months, including 5 cases of Wagner grade 2, 5 cases ofgrade 3 and 5 cases of grade 4).In the process of patients with debridement dressing to return lesions border part of the skin.The wound skin fibroblast cells and new blood vessels observed by histological method,using immunohistochemical method to observe the expression of IGF 1 foot groups.Results Compared with the DM group, serum levels of IGF-1 were significantly lower in the DF group than in the DM group(118.12ng/ml ± 49.96ng/ml vs 136.51ng/ml ±46.14ng/ml, p = 0.018). Furthermore, serum levels of IGF correlated well with the Wagner stage in DF patients. The serum levels of IGF-1 were 139.23ng/ml ± 52.43ng/ml in Wagner grade 1-2 subgroup, 109.82ng/ml ±39.06 ng/ml in the Wagner grade 3 subgroup, and 67.88ng/ml ± 22.98ng/ml in the Wagner grade 4 subgroup, and levels were also significantly different among the three subgroups(F=10.737, p=0.000). Spearman correlation analysis showed that IGF-1 was positively correlated with the Ankle brachial index(ABI) in the DF group, and negatively correlated with Hb A1 c levels(r=-0.233,P=0.046). Regression analysis showed a positive linear regression relationship between serum IGF-1 and ABI(β=36.805,t=2.165,P=0.034) in DM patients nomatter whatever they had diabetic foot or not. Furthermore, our study indicated that in DF group, a negative linear regression relationship exists between serum IGF-1 and Hb A1c(β=-4.439,t=-2.051,P=0.044). Compared with wagner 3 group, fibroblasts and New blood vessels were significantly lower in wagner 4 group, Compared with wagner 2 group, fibroblasts and New blood vessels were significantly lower in wagner 3 group.Immunohistochemical results were suggested, Compared with wagner 3 group, intensity optical density were significantly lower in wagner 4 group(32.44au±9.88 au vs 53.10au±14.49 au p=0.017 p=0.017),Compared with wagner 2 group,intensity optical density were significantly lower in wagner 3 group(53.10au±14.49 au vs 86.48au±10.60 au p=0.001).Conclusion Serum levels of IGF-1 were significantly lower in DF patients. Moreover, the levels of IGF-1 correlated well with the severity of DF ulcers. Serum levels of IGF-1 correlated positively with ABI, but negatively correlated with Hb A1 c. Our results suggest that a decrease in IGF-1 serum levels were a contributing factor to the development of diabetic foot ulcers, and in addition, presents a useful marker for DF diagnosis. It prompts that the decreased expression of IGF- 1 were involved in the occurrence and development of The pathogenesis of diabetic foot.The relationship between toe-brachial index and body fat and its role in type 2 diabetic lower extremity vascular disease risk assessmentAims By analyzing the correlation between toe-brachial index(TBI) and body fat in type 2 diabetic patients(DM),to understand the impact of body fat for TBI in DM,and explore significance of TBI and body fat in evaluating diabetic lower extremity vascular disease.Methods Selected 123 cases of the ankle-brachial index(ABI) and TBI patients were in the normal range of DM,collected demographic characteristics,clincal and biochamical indicators were measured, the main components of the quantitative of different body parts were measured by BCA-2 type a body composition analyzer.TBI were divided into two groups by persantage 50,Group 1:0.82≤TBI<1.12,Group 2:0.6<TBI<0.82.We compared two groups of body composition,and analysed the relationship between the body fat and TBI.Results There were no significant differences of DM duration,ABI, lycosylated hemoglobin A1c(Hb A1c),fasting plasma glucose(FPG),postprandial blood glucose(PBG),triglyceride(TG),total cholesterol(TC),HOMA-IR,high-density lipoproteincholesterol(HDL-C),Low-density lipoprotein-cholesterol(LDL)were found between the two groups.Compared with group 2,systolic blood pressure(SBP) of supine(133.53 mm Hg ±15.35 mm Hg vs 123.85 mm Hg ±26.95 mm Hg,p=0.007), pulse pressure of supine(61.40±15.49 mm Hg vs 51.80 ±25.52 mm Hg,p=0.014), percentage of body fat(29.09%±6.10%vs26.75%±6.28%,p=0.038),Physical age(63.19 years ± 14.04 years vs 56.77 years± 13.50 years,p=0.011),visceral fat/trunk muscles(0.45 ± 0.13 vs 0.40 ± 0.13,p=0.045),fat/muscle of upper limbs(0.45 ± 0.13 vs 0.40 ± 0.13, p=0.043),fat/muscle of lower limbs(0.45 ± 0.13 vs 0.40 ± 0.13,p=0.038) were significantly increased in group 1.Multiple regression analysis showed that physical age(β=-0.002, p=0.003) pulse pressure of orthostatic(β=-0.002, p=0.013), percentage of Body fat(β=-00.004,p= 0.014) were independent risk factors for lowering TBI.Conclusion Our study found that the lower the TBI,the more body fat content,physical age and pulse pressure in DM with normal ABI. Increased body fat content, body age and pulse pressure were independent risk factors for TBI reduced.The result suggested that,it is important to check TBI and body fat for detection and intervention earlier in the risk of lower extremity vascular disease in DM. |
PDF Full Text Request