Tuttolomondo Antonino, Di Raimondo Domenico, Casuccio Alessandra, Guercio Giovanni, Del Cuore Alessandro, Puleo Maria Grazia, Della Corte Vittoriano, Bellia Chiara, Caronia Aurelio, Maida Carlo, Pecoraro Rosaria, Simonetta Irene, Gulotta Gaspare, Ciaccio Marcello, Pinto Antonio
Internal Medicine and Stroke Care Ward, Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro," University of Palermo, Palermo, Italy.
Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro," University of Palermo, Palermo, Italy.
J Clin Endocrinol Metab. 2019 Sep 1;104(9):3920-3930. doi: 10.1210/jc.2018-02507.
No study has analyzed the prevalence of white matter hyperintensities (WMHs) in subjects with diabetic foot syndrome (DFS) and their relationship to adipokine serum levels and indexes of endothelial and cognitive performance.
To evaluate omentin and vaspin serum levels and the prevalence of WMHs in subjects with DFS and to analyze their relationship with other endothelial, arterial stiffness, and cognitive functions.
Case-control study enrolling 40 subjects with DFS, 40 diabetic subjects without foot complications, 40 controls with foot lesions without diabetes, and 40 patients without diabetes mellitus.
Pulse wave velocity (PWV), augmentation index, reactive hyperemia index (RHI), serum vaspin and omentin levels, Fazekas score, and Mini-Mental State Examination (MMSE).
Subjects with DFS showed higher mean PWV values when compared with diabetic controls and lower RHI values when compared with controls. They also showed a lower mean MMSE score, significantly lower omentin serum levels, and a higher prevalence of grade 2 severity of periventricular hyperintensities (PVHs). We observed a significant positive correlation between PWV and PVH and between Fazekas score and PWV among diabetic subjects, whereas among subjects with diabetic foot we observed a significant negative correlation between PVH and RHI.
Diabetes seems to be more associated with endothelial function disturbance in comparison with patients with diabetic foot that exhibit a more strict association with microvascular brain damage as indicated by our significant finding of an association with PVHs.
尚无研究分析糖尿病足综合征（DFS）患者白质高信号（WMHs）的患病率及其与脂肪因子血清水平以及内皮和认知功能指标之间的关系。
评估DFS患者血清网膜素和内脏脂肪素水平以及WMHs的患病率，并分析它们与其他内皮、动脉僵硬度和认知功能之间的关系。
病例对照研究，纳入40例DFS患者、40例无足部并发症的糖尿病患者、40例有足部病变但无糖尿病的对照者以及40例无糖尿病的患者。
脉搏波速度（PWV）、增强指数、反应性充血指数（RHI）、血清内脏脂肪素和网膜素水平、 Fazekas评分以及简易精神状态检查表（MMSE）。
与糖尿病对照组相比，DFS患者的平均PWV值更高；与对照组相比，其RHI值更低。他们的平均MMSE评分也更低，血清网膜素水平显著更低，脑室周围高信号（PVHs）2级严重程度的患病率更高。我们观察到糖尿病患者中PWV与PVH之间以及Fazekas评分与PWV之间存在显著正相关，而在糖尿病足患者中，我们观察到PVH与RHI之间存在显著负相关。
与糖尿病足患者相比，糖尿病似乎与内皮功能障碍的关联更大，而糖尿病足患者与微血管脑损伤的关联更为紧密，这一点从我们发现其与PVHs存在关联这一显著结果中可以看出。
