Determination of p-Cresol Sulphate, Indoxyl Sulfate and phenylpyruvic acid as biomarkers in diabetic foot monitoring
Project no. 21057 · Status: Kapanmış (Yayın bekleniyor) · 2020
Summary
<p>Diabetic foot infection (DAI) is an important and difficult disease to treat in patients with diabetes. It is also the most important complication of diabetes that causes tos tay hospital. Although there are many reasons for the development of DA wound, the main reason is the combined effect of diabetes-related vascular disease and neuropathy. It has been shown that the deterioration of the intestinal microbiota is associated with many diseases such as diabetes mellitus, cancer and obesity. Studies have shown that PKS and IS are associated with cardiovascular disease and mortality in patients with diabetes mellitus. It has been observed that high TMAO levels increased the risk of retinopathy, kidney failure and cardiovascular disease in diabetic patients with diabetes mellitus type2. There are no studies on the importance of microbiota in patients with diabetic foot ulcers. The aim of this study is to investigate the relationship between p-KS, IS, TMAO and FPA levels as blood microbiota indicators in diabetic patients and complications of diabetes. Para-Cresol Sulphate, Indoxyl Sulphate, Phenylpyruvic acid and TMAO measurements were made using the LC-MS/MS. Chitothyroidase activity was determined manually and VEGF and YKL-40 levels were measured y usşng commercially availabel ELISA kits. 30 controls and 86 type 2 DM patients were included in the study. Sixty of the DM patients had different grades of diabetic foot ulcers. CRP and IS levels (p<005) were significantly higher in diabetic patients than controls. CRP, p-KS and VEGF levels (p<005) were significantly higher in patients with diabetic foot than in the control. FPA levels were significantly lower than the control. According to Wagner classification; CRP levels increased as they progressed towards Wagner 5. While FG, AUF and TMAO levels were highest in patients with Wagner-4, p-KS, IS and VEGF levels were highest in patients with Wagner-3. In this project, microbiota markers such as TMAO, p-KS and IS were found to be associated with the presence of complications (especially neuropathy, retinopathy) in diabetic patients. The fact that these indicators were 2-3 times higher in patients with neuropathy, retinopathy or cardiac complications compared to the control group revealed the importance of microbiota in the development of complications. These indicators were the highest in patients with Wagner-3 level wounds which evidenced the role of these molecules in peripheral circulatory disorder in these patients. In the light of this information, approaches to reduce IS,p-KS and TMAO levels can be recommended in the systemic treatment of patients with diabetic foot ulcers in the future.</p>