Features of endothelial dysfunction markers in patients with diabetes mellitus with diabetic foot syndrome

Petro Oleksandrovych Gerasymchuk; Andrii Volodymyrovych Pavlyshyn; Dmytro Bohdanovych Fira; Nataliia Volodymyrivna Volotovska

Petro Oleksandrovych Gerasymchuk Department of General Surgery, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
Andrii Volodymyrovych Pavlyshyn Department of General Surgery, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
Dmytro Bohdanovych Fira Department of General Surgery, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
Nataliia Volodymyrivna Volotovska Department of Physiology, Bioethics and Biosafety, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine

Keywords: endothelial dysfunction, diabetes mellitus, diabetic foot syndrome

Abstract

The study included 100 patients with DFS of grades I-IV according to the Meggitt-Wagner classification. The neuropathic form (NF) was diagnosed in 39 patients, while the ischemic form (IF) was observed in 61 patients. Among the participants, 72 were men, and 28 were women, with a mean age of 62.3 years. Type 1 diabetes was present in 24 patients, and Type 2 diabetes in 76 patients. The duration of DM ranged from 1 to 19 years. Microcirculation was studied using LDF with a “LAKK-02”(Lazma). Patients refrained from eating, smoking, or physical activity for an hour before the test and rested in a supine position for 15 minutes in a temperature-controlled room (20–23°C). These changes can be attributed to the longer disease duration in Type 2 DM patients (mean 12.3±1.3 years) compared to Type 1 DM (mean 4.9±0.7 years) and the presence of prolonged hyperglycemia, which damages the endothelium. Age also played a role, with Type 2 DM patients having a mean age of 67.2±2.5 years versus 46.7±1.8 years in Type 1 DM. Differences were also noted depending on the pathogenetic form of DFS. NO levels in NF were 21.42±1.27 μmol/L, 21.8% lower than control values, whereas IF patients exhibited a 39.7% reduction (16.61±0.87 μmol/L). Conversely, endothelin-1 levels increased by 62.7% (6.45±0.78 pg/mL) in NF and 132.5% (9.27±1.32 pg/mL) in IF DFS.