Correlation Analysis Of Serum Semaphorin3A With High-risk Diabetic Foot In Patients With Type 2 Diabetes Mellitus

Objective:To discover the change of semaphorin3A in patients with type 2 diabates mellitus(T2DM)and high-risk diabetic foot,and to determine the relationship between semaphorin3A and high-risk diabetic foot.Methods:The patients were sorted according to the vibration perception thresholds(VPT)of both feet measured by a quantitative neurometer and the bilateral ankle brachial index(ABI)measured by a standardized doppler ultrasound detector as follows:group A including 46 T2DM patients with the bilateral ABI over than 0.9 and the VPT of both feet less than 25 volt,group B including 42 T2DM patients with at least one side of the ABI equal to or less than 0.9 and the VPT of both feet less than 25 volt,group C including 46 T2DM patients with the bilateral ABI over than 0.9 and the VPT of at least one foot equal to or over than 25 volt,and group D including 42 T2DM patients with at least one side of the ABI equal to or less than 0.9 and the VPT of at least one foot equal to or over than 25 volt.The information of age,sex,smoke history and course of diabetes and blood samples were collected from each subject.The blood samples were used to analyze the following parameters:the fast plasma glucose(FPG),glycated hemoglogin(HbA1c),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C).Andmeasure the systolic blood pressure(SBP)and diastolic blood pressure(SBP)of patients.Then,calculate the Body mass index(BMI)and waist-hip ratio(WHR).The serum semaphorin3A level of each subject was analyzedby the enzyme-linked immunosorbent assay(ELISA).Results:Significant differences were observed in the course of diabetes,age,SBP,FPG,LDL-C and HDL-C among the four groups.The serum semaphorin3A levels of group B,group C and group D were higher than group A(5.21 ± 0.76 ng/ml,5.08± 0.89 ng/ml,5.86±1.28 ng/ml vs 4.36±0.69 ng/ml,p<0.05).The serum semaphorin3A level of group D was higher than group B and group C(p<0.05),and there was no significant difference in semaphorin3A levels between group B and group C(p>0.05).Pearson correlation analysis showed that ABI was positively correlated to age,course of diabetes,SBP,LDL-C and serum semaphorin3A levels(p<0.05),and negatively correlated to HDL-C(p<0.01);VPT was positively correlated to age,course of diabetes,SBP and serum semaphorin3 A levels(p<0.05).Multivariate logistic regression showed that the course of diabetes and LDL-C were the influencing factors for high-risk diabetic foot in T2DM patients complicated with vasculopathy;Replacing serum Semaphorin3A quartile instead of serum Semaphorin3A into multivariate stepwise logistic regression analysis,for every increase of serum semaphorin3 A quantiles,the risk of vasculopathy was 2.65 times as much as the previous quantile;Age and the course of diabetes were the influencing factors for high-risk diabetic foot in T2DM patients complicated with neuropathy.Conclusion:the serum semaphorin3A levels of T2DM patients complicated with high-risk diabetic foot were significantly elevated,which indicated a correlation between semaphorin3A and the development of high-risk diabetic foot.The serum semaphorin3A level was an influencing factor for T2DM patients with high-risk diabetic foot and vasculopathy.