THE HDL LEVEL IN DIABETIC FOOT ULCER PATIENTS WITH AND WITHOUT AMPUTATION AT DR. SEOTOMO GENERAL ACADEMIC HOSPITAL SURABAYA
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Highlights
1. Diabetes mellitus is a category of metabolic disease characterized by uncontrolled hyperglycemia.
2. This study revealed no statistically significant differences in total cholesterol, TG, LDL, HDL, or LDL/HDL ratio between amputated and non-amputated DFU patients.
Abstract
Background: Diabetic foot ulcers (DFU) are microvascular and macrovascular consequences of diabetes and are associated with neuropathy, vascular disease, and immunosuppression. Increased blood glucose levels may result in the glycosylation of proteins in the nerve cells of the foot, leading to ischemia and cellular disturbances that can damage muscular, sensory, and autonomic neurons. Objective: To compare the lipid profiles of amputated and non-amputated DFU patients. Material and Method: This was a cross-sectional, analytic, retrospective research using total sample approach to analyze the medical records of all diabetes patients admitted to Dr. Soetomo General Academic Hospital between February 2018 and December 2020, with or without amputation. Result: The average age of DFU patients at Dr. Soetomo General Academic Hospital was 55.6 9.4 years, and the majority of patients were female (57%). Diabetic foot ulcers were most prevalent in the age group ≥50 years old (74%), amputated DFU patients had larger mean total cholesterol, TG, LDL, and HDL than non-amputated DFU patients, although the difference was not statistically significant. While the mean LDL/HDL ratio was greater in non-amputated DFU patients, the difference was statistically insignificant. The HDL level was low in 84% of amputated DFU patients, whereas in non-amputated DFU patients it was 81%. Conclusion: This research showed no significant variation in total cholesterol, TG, LDL, HDL, or the LDL/HDL ratio between amputated and non-amputated DFU patients. Most DFU patients with and without amputations had low HDL values.
American Diabetes Association. 2012. Medical advice for people with diabetes in emergency situations, ADA.
Atosona, A., Larbie, C. 2019. Prevalence and determinants of diabetic foot ulcers and lower extremity amputations in three selected tertiary hospitals in Ghana. Journal of Diabetes Research, 2019, pp. 1–9. doi: 10.1155/2019/7132861.
Aumiller, W. D., Dollahite, H. A. 2015. Pathogenesis and management of diabetic foot ulcers. Journal of the American Academy of Physician Assistants, 28(5), pp. 28–34. doi: 10.1097/01.JAA.0000464276.44117.b1.
Baltzis, D., Eleftheriadou, I., Veves, A. 2014. Pathogenesis and treatment of impaired wound healing in diabetes mellitus: New insights. Advances in Therapy, 31(8): 817–836. doi: 10.1007/s12325-014-0140-x.
Bekele, F., Chelkeba, L. 2020. Amputation rate of diabetic foot ulcer and associated factors in diabetes mellitus patients admitted to Nekemte referral hospital, western Ethiopia: prospective observational study. Journal of Foot and Ankle Research, 13(1): 65. doi: 10.1186/s13047-020-00433-9.
Bhowmik, B., Siddiquee, T., Mujumder, A., Afsana, F., Ahmed, T., et al. 2018. Serum lipid profile and its association with diabetes and prediabetes in a rural Bangladeshi population. International Journal of Environmental Research and Public Health, 15(9): 1944. doi: 10.3390/ijerph15091944.
Dewi, G. A. A. I. K., Wibisono, S., Pawana, I. P. A. 2020. Risk factors for lower extremity amputation in diabetic foot ulcer patients: A case-control study. JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga, 11(2): 83–85. doi: 10.20473/juxta.V11I22020.83-85.
Firnhaber, J. M., Powell, C. S. 2019. Lower extremity peripheral artery disease: Diagnosis and treatment. American family physician, 99(6): 362–369.
Hirano, T. 2018. Pathophysiology of diabetic dyslipidemia. Journal of Atherosclerosis and Thrombosis, 25(9): 771–782. doi: 10.5551/jat.RV17023.
Husakova, J., Bem, R., Fejfarova, V., Jirkovska, A., Woskova, V., et al. 2022. Factors influencing the risk of major amputation in patients with diabetic foot ulcers treated by autologous cell therapy. Journal of Diabetes Research. Edited by A. C. Panayi, 2022: 1–8. doi: 10.1155/2022/3954740.
Ikura, K., Hanai, K., Shinjyo, T., Uchigata, Y. 2015. HDL cholesterol as a predictor for the incidence of lower extremity amputation and wound-related death in patients with diabetic foot ulcers. Atherosclerosis, 239(2): 465–469. doi: 10.1016/j.atherosclerosis.2015.02.006.
International Diabetes Federation. 2020. Type 2 diabetes prevention. International Diabetes Federation.
International Diabetes Federation. 2021. IDF diabetes atlas. International Diabetes Federation.
Jarl, G., Alnemo, J., Tranberg, R., Lundqvist, L. 2019. Gender differences in attitudes and attributes of people using therapeutic shoes for diabetic foot complications. Journal of Foot and Ankle Research, 12(1): 21. doi: 10.1186/s13047-019-0327-0.
Khan, T., Plotkin, A., Magee, G., Shin, L., Woelfel, S., et al. 2020. Functional ambulatory status as a potential adjunctive decision-making tool following wound, level of ischemia, and severity of foot infection assessment. Journal of Vascular Surgery, 72(2): 738–746. doi: 10.1016/j.jvs.2019.11.064.
Kuang, M., Peng, N., Qiu, J., Zhong, Y., Zou, Y., et al. 2022. Association of LDL:HDL ratio with prediabetes risk: a longitudinal observational study based on Chinese adults. Lipids in Health and Disease, 21(1): 44. doi: 10.1186/s12944-022-01655-5.
Manda, V., Sreedharan, J., Muttappallymyalil, J., Das, R, Hisamatsu, E. 2012. Foot ulcers and risk factors among diabetic patients visiting Surgery Department in a University Teaching Hospital in Ajman, UAE. International Journal of Medicine and Public Health, 2(3): 34–38. doi: 10.5530/ijmedph.2.3.8.
McEneny, J., Daniels, J., McGowan, A., Gunness, A., Moore, K., et al. 2015. A cross-sectional study demonstrating increased serum amyloid a related inflammation in high-density lipoproteins from subjects with type 1 diabetes mellitus and how this association was augmented by poor glycaemic control. Journal of diabetes research, 2015: 351601. doi: 10.1155/2015/351601.
Muhtaroğlu, S., Keti, D. B., Ünlühizarci, K. 2016. Investigation of ischemia-modified albumin levels and some atherosclerosis-related serum parameters in patients with diabetic foot. Turkish Journal of Medical Sciences, 46: 126–132. doi: 10.3906/sag-1406-38.
Musa, I. R. Ahmed, M., Sabir, E., Alsheneber, I., Ibrahim, E., et al. 2018. Factors associated with amputation among patients with diabetic foot ulcers in a Saudi population. BMC Research Notes, 11(1): 260. doi: 10.1186/s13104-018-3372-z.
Namgoong, S., Jung, S., Han, S., Jeong, S., Dhong, E., et al. 2016. Risk factors for major amputation in hospitalised diabetic foot patients. International Wound Journal, 13: 13–19. doi: 10.1111/iwj.12526.
Pei, E., Li, J., Lu, C., Xu, J., Tang, T., et al. 2014. Effects of lipids and lipoproteins on diabetic foot in people with type 2 diabetes mellitus: A meta-analysis. Journal of Diabetes and its Complications, 28(4): 559–564. doi: 10.1016/j.jdiacomp.2014.04.002.
Pemayun, T. G. D., Naibaho, R., Novitasari, D., Amin, N., Minuljo, T. 2015. Risk factors for lower extremity amputation in patients with diabetic foot ulcers: a hospital-based case–control study. Diabetic Foot & Ankle, 6(1): 29629. doi: 10.3402/dfa.v6.29629.
Robbins, B. 2017. The beneficiary. Durham: Duke University Press.
Romadhon, P.Z, Sutjahjo, A., Novida, H., Soelistijo, S.A., Wibisono, S., Prajitno, J.H., Tjokroprawiro, A. 2019. HBA1C and plasma transforming growth factor-beta 1 in type-2 diabetes mellitus patients. New Armenian Medical Journal, 13(1): 69-73.
Shankarprasad, D. , Gundali, S., Kashinakunti, S., et al. 2015. Lipid profile in diabetes mellitus. Indian Journal of Pathology and Oncology, 2(4): 290. doi: 10.5958/2394-6792.2015.00030.7.
Soliman, M. M., Gaber, M. A.-E., Bassaly, B. F. S. 2022. High-density lipoprotein level may be a risk factor for major cardiac events and lower extremity amputation in patients with a diabetic foot ulcer. Journal of Current Medical Research and Practice, 7(2): 116–120. doi: 10.4103/jcmrp.jcmrp_123_20.
Vekic, J., Zeljkovic, A., Al Rasadi, K., Cesur, M., Silva-Nunes, J., et al. 2022. A new look at novel cardiovascular risk biomarkers: The role of atherogenic lipoproteins and innovative antidiabetic therapies. Metabolites, 12(2): 108. doi: 10.3390/metabo12020108.
World Health Organization. 2019. Classification of diabetes mellitus. World Health Organization.
Zeljkovic, A., Vekic, J., Mihajlovic, M., Gojkovic, T., Vladimirov, S., et al. 2021. Revealing the role of high-density lipoprotein in colorectal cancer. International Journal of Molecular Sciences, 22(7): 3352. doi: 10.3390/ijms22073352.
Zhang, L., Chen, S., Deng, A., Liu, X., Liang, Y., et al. 2015. Association between lipid ratios and insulin resistance in a Chinese population. PLOS ONE. Edited by M. Thearle, 10(1): e0116110. doi: 10.1371/journal.pone.0116110.
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