Wang Jixue, Yang Xirui, Zhou Tao, Ma Haitao, Yuan Xingxing, Yan Shuxun
Department of Peripheral Vascular Medicine, First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China.
Department of Ophthalmology, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China.
Open Life Sci. 2025 Aug 8;20(1):20251137. doi: 10.1515/biol-2025-1137. eCollection 2025.
Diabetic foot ulcer (DFU) is a severe and prevalent complication of diabetes mellitus, posing substantial risks to patient health and increasing healthcare burdens globally. These chronic wounds often result from a complex interplay of factors, including neuropathy, ischemia, infection, immune dysregulation, and vascular dysfunction, leading to significant morbidity and, in severe cases, amputation. Effective management of DFUs necessitates a comprehensive understanding of their risk factors and prognostic indicators. This review provides an in-depth examination of the various risk factors and prognostic markers associated with DFUs, integrating insights from cellular mechanisms, emerging biomarkers, omics-based research, serological studies, and clinical assessments. We explore the underlying biological processes, such as the impact of chronic hyperglycemia, oxidative stress, inflammation, impaired angiogenesis, and the role of the microbiome in DFU development. The role of serological markers, including inflammatory and glycemic indicators, in predicting DFU risk and progression is discussed. Additionally, clinical markers and advanced assessment tools, such as ulcer grading systems and imaging technologies, used to evaluate DFU severity and healing are reviewed. By synthesizing these diverse perspectives, this review aims to offer a holistic view of DFU management, highlighting how understanding the interplay of risk factors and prognostic markers can lead to improved prevention strategies and personalized therapeutic interventions.
糖尿病足溃疡（DFU）是糖尿病一种严重且常见的并发症，对患者健康构成重大风险，并在全球范围内加重医疗负担。这些慢性伤口通常是由多种因素复杂相互作用导致的，包括神经病变、缺血、感染、免疫失调和血管功能障碍，会引发严重疾病，严重时会导致截肢。有效管理糖尿病足溃疡需要全面了解其风险因素和预后指标。本综述深入探讨了与糖尿病足溃疡相关的各种风险因素和预后标志物，整合了细胞机制、新兴生物标志物、组学研究、血清学研究和临床评估等方面的见解。我们探究了潜在的生物学过程，如慢性高血糖、氧化应激、炎症、血管生成受损的影响，以及微生物群在糖尿病足溃疡发展中的作用。讨论了血清学标志物，包括炎症和血糖指标，在预测糖尿病足溃疡风险和进展中的作用。此外，还综述了用于评估糖尿病足溃疡严重程度和愈合情况的临床标志物以及先进评估工具，如溃疡分级系统和成像技术。通过综合这些不同观点，本综述旨在提供糖尿病足溃疡管理的整体视角，强调理解风险因素和预后标志物的相互作用如何能带来更好的预防策略和个性化治疗干预措施。
