Oxidative Stress Marker and Fibrinogen Level as Indicators of Severity of Diabetic Foot Ulcer

Abstract

AbstractDiabetic foot ulcer (DFU) is the leading cause of lower extremity amputation and is very common in clinical practice. Oxidative stress is important in the pathogenesis of chronic wound and the lipid per oxidation product malondialdehyde (MDA) is toxic molecule which is also associated with pathogenesis of chronic complications of diabetes mellitus. Fibrinogen is a recognized marker in peripheral arterial disease (PAD) and increasing level predict an increased risk of amputation. The aim of this study was to investigate whether the plasma MDA and fibrinogen are associated with severity of DFU. In this study, the plasma MDA and fibrinogen levels were determined in 23 normal subjects, 25 diabetes without ulcer patients, 24 mild DFU patients and 25 severe DFU patients. The results showed that mean plasma MDA levels of normal subjects, diabetes without foot ulcer patients, mild DFU patients and severe DFU patients were 0.98± 0.12 μmol/L, 1.3±0.21 μmol/L, 1.61±0.22 μmol/L and 2.3±0.35 μmol/L respectively. Mean plasma fibrinogen levels of normal subjects, diabetes without foot ulcer patients, mild DFU patients and severe DFU patients were 307± 61.5 mg/dl, 429±63.8 mg/dl, 513.6±77.8 mg/dl and 643.5±71.3 mg/dl respectively. We found out that mean plasma MDA level of severe DFU patients was significantly higher than that of other groups (p<0.001). Similarly, mean plasma fibrinogen level of severe DFU patients was significantly higher than that of normal subjects, diabetic without ulcer patients and mild DFU patients (p<0.001). Therefore, we concluded that the higher level of plasma MDA and fibrinogen are significantly associated with severity of DFU.