糖尿病足溃疡患者血清25-羟维生素D水平升高。
Raised serum 25-hydroxyvitamin D levels in patients with active diabetic foot ulcers.
作者信息
Afarideh Mohsen, Ghanbari Parvaneh, Noshad Sina, Ghajar Alireza, Nakhjavani Manouchehr, Esteghamati Alireza
机构信息
Endocrinology and Metabolism Research Center (EMRC),Vali-Asr Hospital,School of Medicine,Tehran University of Medical Sciences,PO Box 13145-784,Tehran,Iran.
出版信息
Br J Nutr. 2016 Jun;115(11):1938-46. doi: 10.1017/S0007114516001094.
Studies have emerged to demonstrate bidirectional changes in circulating cytokines of inflammation in active diabetic foot ulcers (DFU). To further expand the understanding of inflammatory status present in chronic active DFU, we comparatively assessed the associations of selected pro-inflammatory cytokines and 25-hydroxyvitamin D (25(OH)D) with the presence of DFU. In a cross-sectional setting, thirty patients with type 2 diabetes and active DFU matched with thirty control non-ulcerative patients with type 2 diabetes and twenty-eight healthy subjects underwent anthropometric and biochemical assessment of study parameters. Recruited patients with DFU were selected from the grade II active chronic DFU at the time of hospitalisation according to the University of Texas wound classification system. Patients with DFU and controls had comparable age, sexual distribution, diastolic blood pressure and TAG, LDL-cholesterol and glycated Hb. The trend changes from healthy controls towards DFU showed a significant increase for serum monocyte chemoattractant protein-1, IL-6, 25(OH)D and highly sensitive C-reactive protein and a decrease for IL-8. In the multivariate adjusted logistic regression model, 25(OH)D emerged as the only independent correlate of DFU (OR 2·194; 95 % CI 1·003, 4·415). Unprecedented increase of serum 25(OH)D in chronic active DFU is possibly related to a selective alteration in the inflammatory status. In particular, 25(OH)D and IL-8 seem to share a common pathway in the pathogenesis of diabetic foot.
已有研究表明,在活动性糖尿病足溃疡(DFU)中,循环炎症细胞因子存在双向变化。为了进一步加深对慢性活动性DFU炎症状态的理解,我们比较评估了所选促炎细胞因子和25-羟基维生素D(25(OH)D)与DFU存在情况之间的关联。在一项横断面研究中,30例2型糖尿病合并活动性DFU患者、30例2型糖尿病非溃疡对照患者以及28例健康受试者接受了研究参数的人体测量和生化评估。根据德克萨斯大学伤口分类系统,入选的DFU患者为住院时的II级活动性慢性DFU患者。DFU患者和对照组在年龄、性别分布、舒张压、甘油三酯、低密度脂蛋白胆固醇和糖化血红蛋白方面具有可比性。从健康对照到DFU的趋势变化显示,血清单核细胞趋化蛋白-1、IL-6、25(OH)D和高敏C反应蛋白显著升高,而IL-8降低。在多变量调整逻辑回归模型中,25(OH)D是DFU的唯一独立相关因素(比值比2·194;95%可信区间1·003,4·415)。慢性活动性DFU中血清25(OH)D前所未有的升高可能与炎症状态的选择性改变有关。特别是,25(OH)D和IL-8似乎在糖尿病足发病机制中共享一条共同途径。