糖尿病足患者血清网膜素-1和血管内皮生长因子水平与Wagner分级的相关性

Correlations of serum omentin-1 and vascular endothelial growth factor levels with Wagner grade in diabetic foot patients

目的 观察糖尿病足患者血清网膜素-1(omentin-1)、血管内皮生长因子(vascular endothelial growth factor,VEGF)水平变化,探讨其与糖尿病足Wagner分级的相关性。方法 糖尿病足患者120例为糖尿病足组,其中Wagner分级2级48例,3级37例,4级35例;2型糖尿病患者120例为2型糖尿病组,同期体检健康者120例为对照组,采用ELISA法检测3组血清omentin-1、VEGF水平,并进行比较。比较不同Wagner分级糖尿病足患者血清omentin-1、VEGF水平及糖尿病病程、糖尿病足病程和空腹血糖、糖化血红蛋白等实验室指标,采用Spearman相关法分析糖尿病足患者血清omentin-1、VEGF水平与Wagner分级的相关性,采用多因素logistic回归分析糖尿病足患者Wagner分级的影响因素。结果 糖尿病足组血清omentin-1[(130.46±21.52)μg/L]、VEGF[(63.27±18.63)ng/L]水平均低于2型糖尿病组[(160.32±20.45)μg/L、(390.42±46.21)ng/L]、对照组[(198.37±25.64)μg/L、(102.35±25.30)ng/L](P<0.05),2型糖尿病组血清omentin-1水平低于对照组(P<0.05),VEGF水平高于对照组(P<0.05)。Wagner分级2级、3级、4级糖尿病足患者血清omentin-1、VEGF水平均依次降低(P<0.05),糖尿病病程、糖尿病足病程均依次增长(P<0.05),糖尿病周围神经病变比率及空腹血糖、糖化血红蛋白、白细胞计数、三酰甘油、C反应蛋白、降钙素原水平均依次升高(P<0.05)。糖尿病足患者血清omentin-1、VEGF水平与Wagner分级均呈负相关(r=-0.472,P<0.001;r=-0.442,P<0.001)。血清omentin-1(OR=0.377,95%CI:0.228~0.622,P<0.001)、VEGF(OR=0.353,95%CI:0.196~0.637,P<0.001)是糖尿病足患者Wagner分级的影响因素。结论 糖尿病足患者血清omentin-1、VEGF水平降低,Wagner分级越高,血清omentin-1、VEGF水平越低;omentin-1、VEGF可能成为评估糖尿病足患者病情严重程度的指标。

Objective To observe the levels of serum omentin-1 and vascular endothelial growth factor(VEGF) in patients with diabetic foot,and to explore their correlations with Wagner grade.Methods Totally 120 patients with diabetic foot(diabetic foot group) were divided into 48 patients with Wagner grade 2,37 patients with grade 3,and 35patients with grade 4.Another 120 patients with type 2 diabetes mellitus(T2DM) were as T2DM group,and 120 healthy volunteers in the same period were as control group.The serum omentin-1 and VEGF levels were detected by ELISA and compared among three groups.The serum levels of omentin-1 and VEGF,course of diabetes,course of diabetic foot,and laboratory indexes such as fasting plasma glucose and glycosylated hemoglobin were compared among diabetic foot patients with different Wagner grades.Spearman correlation method was used to analyze the correlations of serum omentin-1 and VEGF levels with Wagner grade in patients with diabetic foot,and multivariate logistic regression was done to analyze the influencing factors of Wagner grading in patients with diabetic foot.Results The levels of serum omentin-1 and VEGF were lower in diabetic foot group [(130.46 ± 21.52) μg/L,(63.27±18.63) ng/L] than those in T2DM group[(160.32±20.45) μg/L,(390.42±46.21) ng/L] and control group [(198.37±25.64) μg/L,(102.35±25.30) ng/L](P<0.05),the level of serum omentin-1 was lower in T2DM group than that in control group(P<0.05),and the level of VEGF was higher in T2DM group than that in control group(P<0.05).The serum levels of omentin-1 and VEGF decreased sequentially in diabetic foot patients with Wagner grade 2,3 and 4(P<0.05),while the course of diabetes,course of diabetic foot,incidence of diabetic peripheral neuropathy,and levels of fasting plasma glucose,glycosylated hemoglobin,white blood cell count,triacylglycerol,C-reactive protein and procalcitonin increased sequentially(P<0.05).The serum levels of omentin-1 and VEGF in patients with diabetic foot were negatively correlated with Wagner grade(r=-0.472,P<0.001;r=-0.442,P<0.001).Serum omentin-1(OR=0.377,95% CI:0.228-0.622,P<0.001) and VEGF(OR=0.353,95% CI:0.196-0.637,P<0.001) were the influencing factors of Wagner grading in diabetic foot patients.Conclusions The serum levels of omentin-1 and VEGF decrease in diabetic foot patients.The higher the Wagner grade,the lower the serum levels of omentin-1 and VEGF.Serum omentin-1 and VEGF may become indicators to judge the severity of diabetic foot.