A study on association of fibrinogen and oxidative stress in prognosis of diabetic foot ulcer in tertiary government hospital

Author : Dr. Naga Raju Vubbana and Dr. D. Muralidhar

Diabetes mellitus is the most common metabolic disorder characterized by metabolic abnormalities and long term complications. Diabetic foot ulcer has poor prognosis and is a leading cause of amputation. Oxidative stress is associated with the pathogenesis of chronic wounds. Fibrinogen is a prognostic marker of peripheral vascular disease. This prospective case-control study was designed to (i) evaluate and compare oxidative stress, protein carbonyl and fibrinogen levels, (ii) assess the correlation of the above parameters with prognosis in diabetic foot ulcer patients and healthy controls and (iii) whether fibrinogen levels can be used as prognostic markers.The study included 60 diabetic patients (30 diabetic foot ulcer grade 1 and 30 grade 2 patients). Oxidative stress was evaluated by estimating the amount of oxidant load of lipid peroxides by ferrous oxidation products in xylenol orange assay in conjunction with triphenylphosphine version 2 (FOX2 assay) and protein carbonyl. The antioxidant status level was estimated by ferric reducing ability of serum (FRAP assay). Fibrinogen and glycated hemoglobin was measured using commercial kits. SPSS version 17 was used for statistical analysis. Oxidative stress was higher in diabetic foot ulcer grade 2 patients compared to DFU grade1. Increased oxidative stress and plasma fibrinogen correlated with poor prognosis. Increased oxidative stress and plasma fibrinogen are associated with poor prognosis irrespective of glycemic control.

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