Yang Pengbo, Sun Guanwen, Bao Huhe, Zhang Wanyin, Wang Lihang, Huang Fei, Zhang Yaxing
Inner Mongolia Medical University Hohhot 010000, Inner Mongolia Autonomous Region, China.
Department of Orthopedics, Inner Mongolia Autonomous Region People's Hospital Hohhot 010000, Inner Mongolia Autonomous Region, China.
Am J Transl Res. 2025 Aug 15;17(8):6092-6102. doi: 10.62347/ILFJ9140. eCollection 2025.
This study aimed to investigate the alterations of miR-132, miR-155, vascular endothelial growth factor (VEGF), and insulin-like growth factor-1 (IGF-1) expression in patients with diabetic foot infection (DFI), and to analyze and the distribution of pathogenic microorganisms, with the goal of elucidating underlying molecular mechanisms and identifying potential diagnostic and therapeutic biomarkers.
A retrospective analysis was conducted on 114 patients with diabetic foot, who were divided into two groups: an observation group (n = 56) comprising patients with DFI, and a control group (n = 58) without infection. The primary outcomes included the expression levels of miR-132, miR-155, VEGF, and IGF-1, as well as microbial profiles isolated from infected wound sites. Secondary outcomes encompassed inflammatory markers [C-reactive protein (CRP), white blood cell count (WBC), interleukin-6 (IL-6), procalcitonin (PCT)], biochemical markers [fasting glucose, glycated hemoglobin (HbA1c), lipid profile], and hormonal markers [cortisol, thyroid-stimulating hormone (TSH), growth hormone (GH), and leptin].
Microbiological cultures identified Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli as the predominant pathogens in DFI cases, with a mixed infection observed in a subset. Expression levels of miR-132 (5.6 ± 1.2 vs. 2.3 ± 0.5, P < 0.001), miR-155 (4.8 ± 1.1 vs. 1.9 ± 0.6, P < 0.001), VEGF (245.3 ± 32.5 pg/mL vs. 150.7 ± 25.3 pg/mL, P < 0.001), and IGF-1 (182.4 ± 30.6 pg/mL vs. 124.8 ± 21.7 pg/mL, P < 0.001) were significantly upregulated in the observation group compared to controls, suggesting their involvement in the pathogenesis of DFI. Inflammatory and biochemical markers were markedly elevated in the observation group (P < 0.001), reflecting systemic inflammation and metabolic dysregulation. Hormonal analysis revealed increased cortisol and insulin levels, along with decreased TSH, GH, and leptin levels (P < 0.001). Additionally, significant negative correlations were found between miR-132/miR-155 and VEGF/IGF-1, indicating potential regulatory interactions in the context of inflammation and vascular remodeling (P < 0.001).
Elevated expression of miR-132, miR-155, VEGF, and IGF-1, together with characteristic microbial profiles, plays a critical role in the pathogenesis of DFI. These molecules may serve as promising biomarkers for disease diagnosis and therapeutic monitoring.
本研究旨在调查糖尿病足感染（DFI）患者中miR-132、miR-155、血管内皮生长因子（VEGF）和胰岛素样生长因子-1（IGF-1）表达的变化，并分析致病微生物的分布，以阐明潜在的分子机制并确定潜在的诊断和治疗生物标志物。
对114例糖尿病足患者进行回顾性分析，将其分为两组：观察组（n = 56）为DFI患者，对照组（n = 58）为未感染患者。主要结局包括miR-132、miR-155、VEGF和IGF-1的表达水平，以及从感染伤口部位分离出的微生物谱。次要结局包括炎症标志物[C反应蛋白（CRP）、白细胞计数（WBC）、白细胞介素-6（IL-6）、降钙素原（PCT）]、生化标志物[空腹血糖、糖化血红蛋白（HbA1c）、血脂谱]和激素标志物[皮质醇、促甲状腺激素（TSH）、生长激素（GH）和瘦素]。
微生物培养确定金黄色葡萄球菌、铜绿假单胞菌和大肠杆菌是DFI病例中的主要病原体，部分病例存在混合感染。与对照组相比，观察组中miR-132（5.6±1.2对2.3±0.5，P<0.001）、miR-155（4.8±1.1对1.9±0.6，P<0.001）、VEGF（245.3±32.5 pg/mL对150.7±25.3 pg/mL，P<0.001）和IGF-1（182.4±30.6 pg/mL对124.8±21.7 pg/mL，P<0.001）的表达水平显著上调，表明它们参与了DFI的发病机制。观察组的炎症和生化标志物显著升高（P<0.001），反映了全身炎症和代谢失调。激素分析显示皮质醇和胰岛素水平升高，同时TSH、GH和瘦素水平降低（P<0.001）。此外，发现miR-132/miR-155与VEGF/IGF-1之间存在显著负相关，表明在炎症和血管重塑背景下可能存在调节相互作用（P<0.001）。
miR-132、miR-155、VEGF和IGF-1的表达升高，以及特征性的微生物谱，在DFI的发病机制中起关键作用。这些分子可能是疾病诊断和治疗监测的有前途的生物标志物。
