格雷姆林-1和瓦格纳分类:糖尿病足患者截肢的潜在生物标志物
Şeyma Açık1, Şevki Çetinkalp2, Çiğdem Gözde Aslan3
1Department of Endocrinology and Metabolic Diseases, Antalya Training and Research Hospital, Antalya, Turkey.
The international journal of lower extremity wounds
|April 28, 2025
概括
血清格雷姆林-1水平随着糖尿病脚 (DF) 严重程度和截肢风险的增加而降低. 下格雷姆林-1可能表明DF患者截肢的可能性更高.
科学领域:
- 内分泌学 在内分泌学.
- 血管外科 血管外科
- 糖尿病学 糖尿病学
背景情况:
- 糖尿病脚 (DF) 是糖尿病的严重并发症,其特点是患病率和死亡率高.
- 神经病变和缺血是DF发展和进展的主要驱动因素.
- 确定DF可靠的预后标志物对于及时干预和肢体救援至关重要.
研究的目的:
- 通过瓦格纳分类来分层调查血清格雷姆林-1水平与糖尿病足病严重程度之间的关联.
- 评估Gremlin-1作为糖尿病患者下肢截肢预测生物标志物的潜力.
- 探索Gremlin-1水平和糖尿病足患者的关键代谢参数之间的相关性.
主要方法:
- 研究了85名患有糖尿病足或患有糖尿病足高风险的患者队列.
- 血清格雷姆林-1水平使用酶相关免疫吸收检测 (ELISA) 方法量化.
- 使用瓦格纳分类来评估疾病严重程度;审查了实验室数据和患者并发症.
主要成果:
- 血清格雷姆林-1水平显示,随着糖尿病足病的瓦格纳阶段的进展,血清格雷姆林-1水平显著下降 (p=0.05).
- 截肢患者的血清格雷姆林-1水平显著降低 (p<0.05).
- 格雷姆林-1在预测截肢时表现出67%的灵敏度和46%的特异性,截肢的临界值为2.47 ng/ml;与总胆固醇,LDL和禁食葡萄糖观察到正相关性.
结论:
- 血清格雷姆林-1水平与糖尿病足病严重程度相反相关,并且在需要截肢的患者中显著降低.
- 格雷姆林-1可以作为一个有价值的预后生物标志物,用于预测糖尿病足患者截肢的需要.
- 格雷姆林-1在DF病变发生过程中的确切作用和机制需要进一步研究.
相关概念视频
01:27Glucose Transporters
15.2K
Glucose transporters facilitate the transport of glucose across the cell membrane. In addition to glucose, some glucose transporters can also aid the movement of other hexoses such as fructose, mannose, and galactose.
Facilitated diffusion-glucose transporters (GLUTs) are encoded by the solute-linked carrier (SLC) family 2, subfamily A gene family, or SLC2A. The 14 GLUT protein members are distributed into three classes:
Facilitated diffusion-glucose transporters (GLUTs) are encoded by the solute-linked carrier (SLC) family 2, subfamily A gene family, or SLC2A. The 14 GLUT protein members are distributed into three classes:
15.2K
01:24Glucagon-like Receptor Agonists
1.3K
Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
1.3K
01:25Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
17
Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated...
17
01:26Hypoglycemia
30
Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
30
01:29Hyperglycemia
25
Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose...
25
01:28Diabetic Nephropathy
32
Definition Diabetic nephropathy is a chronic kidney complication that results from prolonged hyperglycemia.Prevalence It is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, affecting up to half of individuals with diabetes.Pathophysiology • Sustained hyperglycemia triggers multiple hemodynamic and metabolic changes in the kidney. • Early in the disease, increased renal blood flow and glomerular hyperfiltration...
32