Departments of Burn and Wound Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Departments of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Wound Repair Regen. 2021 Jan;29(1):97-105. doi: 10.1111/wrr.12876. Epub 2020 Nov 16.
This study aimed to investigate the relationship between the severity of albuminuria and wound healing in type 2 diabetic foot ulcers. A total of 121 patients with diabetic foot ulcers were recruited from January 2015 to June 2017 and divided into nonproliferation and proliferation groups according to their healing status. Univariate and multivariate logistic regression were performed to assess the risk factors of wound proliferation. Skin biopsies were also taken from normal tissue near the wound in 54 participants. The microvessel density as well as the relationships among the microvessel density, albuminuria and wound proliferation were evaluated. Results showed that in a multiple linear regression model, factors including body-mass index, microalbuminuria, and macroalbuminuria showed independently significant association with wound healing in patients. The receiver operating characteristic curve analysis indicated albuminuria as a predicator for wound healing with a cutoff value of 32 mg/g. Meanwhile, normoalbuminuric patients showed significantly higher level of skin microvessels density than microalbuminuria and macroalbuminuria patients, while microalbuminuria patients also had statistically more microvessels that macroalbuminuria patients. The microvessel density were statistically significantly higher in the proliferation group than that in the nonproliferation group. In summary, this study suggested that albuminuria can be used as an independent indicator for the healing of type 2 diabetic foot ulcers.
本研究旨在探讨 2 型糖尿病足溃疡患者蛋白尿严重程度与伤口愈合的关系。2015 年 1 月至 2017 年 6 月共招募 121 例糖尿病足溃疡患者,根据愈合情况分为非增殖组和增殖组。采用单因素和多因素 logistic 回归分析评估伤口增殖的危险因素。还从 54 名参与者的伤口附近正常组织中采集皮肤活检。评估微血管密度以及微血管密度、蛋白尿与伤口增殖之间的关系。结果显示,在多元线性回归模型中,包括体重指数、微量白蛋白尿和大量白蛋白尿在内的因素与患者的伤口愈合有独立显著相关性。受试者工作特征曲线分析表明,白蛋白尿是伤口愈合的预测因子,截断值为 32mg/g。同时,与微量白蛋白尿和大量白蛋白尿患者相比,正常白蛋白尿患者的皮肤微血管密度明显更高,而微量白蛋白尿患者的微血管数量也明显多于大量白蛋白尿患者。增殖组的微血管密度明显高于非增殖组。总之,本研究表明,白蛋白尿可作为 2 型糖尿病足溃疡愈合的独立指标。