Clinical Pathology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt.
Vascular Surgery, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt.
J Diabetes Investig. 2023 Oct;14(10):1192-1201. doi: 10.1111/jdi.14048. Epub 2023 Jul 2.
AIMS/INTRODUCTION: Peripheral artery disease (PAD) serves as a risk factor for diabetic foot ulcers (DFUs). PAD pathology involves atherosclerosis and impaired immunity. Non-classical monocytes are believed to have an anti-inflammatory role. 1,25-Dihydroxy vitamin D (vitamin D ) is claimed to have immune-modulating and lipid-regulating roles. Vitamin D receptor is expressed on monocytes. We aimed to investigate if circulating non-classical monocytes and vitamin D were implicated in DFUs associated with PAD.
There were two groups of DFU patients: group 1 (n = 40) included patients with first-degree DFUs not associated with PAD, and group 2 (n = 50) included patients with DFU with PAD. The monocyte phenotypes were detected using flow cytometry. Vitamin D was assessed by enzyme-linked immunosorbent assay.
DFU patients with PAD showed a significant reduction in the frequency of non-classical monocytes and vitamin D levels, when compared with DFU patients without PAD. The percentage of non-classical monocytes positively correlated with vitamin D level (r = 0.4, P < 0.01) and high-density lipoprotein (r = 0.5, P < 0.001), whereas it was negatively correlated with cholesterol (r = -0.5, P < 0.001). Vitamin D was negatively correlated with triglyceride/high-density lipoprotein (r = -0.4, P < 0.01). Regression analysis showed that a high vitamin D serum level was a protective factor against PAD occurrence.
Non-classical monocytes frequency and vitamin D levels were significantly reduced in DFU patients with PAD. Non-classical monocytes frequency was associated with vitamin D in DFUs patients, and both parameters were linked to lipid profile. Vitamin D upregulation was a risk-reducing factor for PAD occurrence.
目的/引言：外周动脉疾病（PAD）是糖尿病足溃疡（DFU）的危险因素。PAD 病理涉及动脉粥样硬化和免疫受损。非经典单核细胞被认为具有抗炎作用。1,25-二羟维生素 D（维生素 D）被认为具有免疫调节和脂质调节作用。维生素 D 受体在单核细胞上表达。我们旨在研究循环非经典单核细胞和维生素 D 是否与 PAD 相关的 DFU 有关。
DFU 患者分为两组：组 1（n=40）包括无 PAD 的一级 DFU 患者，组 2（n=50）包括有 PAD 的 DFU 患者。使用流式细胞术检测单核细胞表型。通过酶联免疫吸附试验评估维生素 D。
与无 PAD 的 DFU 患者相比，PAD 的 DFU 患者的非经典单核细胞频率和维生素 D 水平显著降低。非经典单核细胞的百分比与维生素 D 水平呈正相关（r=0.4，P<0.01）和高密度脂蛋白（r=0.5，P<0.001），而与胆固醇呈负相关（r=-0.5，P<0.001）。维生素 D 与甘油三酯/高密度脂蛋白呈负相关（r=-0.4，P<0.01）。回归分析显示，高血清维生素 D 水平是 PAD 发生的保护因素。
PAD 的 DFU 患者中非经典单核细胞频率和维生素 D 水平显著降低。非经典单核细胞频率与 DFU 患者的维生素 D 相关，这两个参数均与脂质谱有关。维生素 D 的上调是 PAD 发生的降低风险因素。
