HDL cholesterol as a predictor for the incidence of lower extremity amputation and wound-related death in patients with diabetic foot ulcers

Ikura, Kazuki; Hanai, Ko; Shinjyo, Takamichi; Uchigata, Yasuko

doi:10.1016/j.atherosclerosis.2015.02.006

Cited by 40 publications

(43 citation statements)

References 32 publications

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“…19 Low HDL levels have also been studied and implicated as prognostic factors for amputations at all levels in diabetics with plantar ulcers. 20 In turn, arterial calcification and distal vascular incompressibility in diabetics are considered prognostic factors of amputation equally as important as the ankle-brachial index. 21 The present study identified that reduced hematocrit and hemoglobin levels were significantly more likely to be present in patients who underwent major amputations compared to those subjected to minor amputations.…”

Section: 15mentioning

confidence: 99%

Análise dos fatores de risco relacionados às amputações maiores e menores de membros inferiores em hospital terciário

Jesus-Silva¹,

Oliveira²,

Brianezi³

et al. 2017

J. vasc. bras.

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Background: Whether they are defined as minor or major, lower limb amputations constitute a severe health problem, causing high rates of morbidity and mortality and considerable social impact. Different patient clinical characteristics appear to be related to different types of amputations. Objectives: To analyze risk factors present in patients who underwent lower limb amputations at a tertiary hospital. Methods: This was a retrospective, cross-sectional study of 109 patients who underwent lower limb amputations over a period of 31 months, analyzing gender, age, 15 clinical data and five laboratory parameters present at the time of admission. Data were treated with descriptive statistics and compared using Student' s t test for unpaired samples (for numerical variables), the Mann-Whitney test, or Fisher' s exact tests (for categorical variables). Results: There were 59 major and 50 minor amputations out of a total of 109 performed. The majority of patients were male (65%) and mean age was 65 years (range 39 to 93). Risk factors that were statistically (p < 0.05) more related to major amputations were advanced age, stroke, ischemia, sepsis, and low hemoglobin and hematocrit levels. Diabetes mellitus, neuropathy, and palpable distal pulses were factors more strongly associated with minor amputations. Conclusions: Lower limb amputations at different levels are related to different risk factors. Ischemia of greater severity and morbidity was associated with major amputations, while neuropathy and preserved perfusion were more often related to minor amputations.

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Section: 15mentioning

confidence: 99%

Análise dos fatores de risco relacionados às amputações maiores e menores de membros inferiores em hospital terciário

Jesus-Silva¹,

Oliveira²,

Brianezi³

et al. 2017

J. vasc. bras.

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“…This suggests that the occurrence of diabetic foot ulcers occurs in the fifth and sixth decades. 7,9 The age group with the most diabetic foot ulcers was age over 60 years (45.9%) followed by age 50-59 years (35.2%) and the lowest at 40-49 years old (18.9%), this is also explained by Zubair et al (2015), that the prevalence of diabetic foot ulcers increases with age over 40 years. 1 In a study conducted by Manda et al, there was also a distribution of diabetic foot ulcers found in more than 75 percent aged 30 to 60 years, and the highest number at age 50-59 years (42.5%).…”

Section: Discussionmentioning

confidence: 89%

“…6 Approximately 15-25% of patients with diabetes mellitus will develop into diabetic foot during their lifetime. 7 Diabetic foot ulcers are a major cause of amputation in non-traumatic patients, about 85% of amputations in diabetic foot ulcers are due to extensive infection or gangrene. 4,8 Amputation of the lower limb is one of the most feared complications in DM patients because it affects the health and quality of life of the patient.…”

mentioning

confidence: 99%

“…4,8 Amputation of the lower limb is one of the most feared complications in DM patients because it affects the health and quality of life of the patient. 7 The risk of amputation increased in diabetic patients with peripheral neuropathy, where peripheral neuropathy leads to loss of sensation and ability to detect problems occurring in the legs causing changes that may increase pressure on the feet resulting in ulcers. 9 The treatment required for current diabetic foot ulcers is by providing optimal blood supply, handling at pressures on the sole, preventing and controlling the right infection.…”

mentioning

confidence: 99%

“…A previous study by Ikura et al showed a correlation of low HDL cholesterol levels with severity in diabetic foot ulcers with an increased incidence of infection, and they also evaluated the hypothesis that HDL cholesterol was a predictor of amputation and injury in patients with ulcers diabetic foot. 7 High-Density Lipoprotein (HDL) has a role in reverse cholesterol transport (RCT), but it also has a direct role that affects cardiovascular and another metabolism. 12 In endothelial cells, HDL decreases apoptosis, stimulates endothelial cell proliferation and migration, anti-inflammatory and antithrombotic effects.…”

mentioning

confidence: 99%

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Correlation of HDL cholesterol serum and Wagner’s severity level of diabetic foot ulcers

Kartono¹,

Mallapasi²,

Mulawardi³

et al. 2017

Int J Res Med Sci

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Background: Diabetic foot ulcers are one of the leading causes of amputation in non-traumatic patients. This research aimed to investigate the correlation between the level of HDL cholesterol and the severity level of diabetic foot ulcer based on Wagner classification. The study conducted at Wahidin Sudirohusodo Hospital, Makassar, Indonesia.Methods: This is an observational study with the cross-sectional design. The data collected before and after the treatment. The change of the levels of HDL cholesterol and the severity level of the diabetic foot ulcer based on Wagner classification during the treatment were analyzed. Data analyzed using Spearman Correlation test, the paired t-test to assess the change in the levels of HDL cholesterol and the levels of severity of diabetic foot ulcer based on Wagner classification at the time admission and after the treatment. ANOVA test was used to observe the reduction significance of the severity of diabetic foot ulcer based on Wagner classification, and it was categorized as significant if p<0.05.Results: The results indicated that there is a correlation between the level of HDL cholesterol and the severity level of diabetic foot ulcer based on Wagner classification either at the early treatment with p-value = 0.003 (r = - 0.448) and the end of the treatment with p-value = 0.001(r = - 0.477). The lower of the level of cholesterol HDL, the higher was the severity level of the diabetic foot ulcer. Meanwhile, the correlation between the increase of the level of HDL cholesterol and the reduction of Wagner classification during the treatment was statistically insignificant with p-value = 0.100 (r = - 0.215).Conclusions: there was a correlation between elevated HDL cholesterol levels during treatment with Wagner classification decrease during treatment, the higher the HDL change, the higher the Wagner classification, but this was weak correlation and statistically insignificant.

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Curcumin nanofibers for the purpose of wound healing

Fereydouni

Darroudi

Movaffagh

et al. 2018

Journal Cellular Physiology

127

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Poor wound healing is a highly prevalent clinical problem with, as yet, no entirely satisfactory solution. A new technique, termed electrospinning, may provide a solution to improve wound healing. Due to their large surface area to volume ratio and porosity, the nanofibers created by electrospinning are able to deliver sustained drug release and oxygen to the wound. Using different types of polymers with varying properties helps strengthening nanofiber and exudates absorption. The nanofibers appear to have an ideal structure applicable for wound healing and, in combination with curcumin, can blend the anti-inflammatory and antioxidant properties of curcumin into a highly effective wound dressing. The use of suitable curcumin solvents and the slow release of curcumin from the nanofiber help in overcoming the known limitations of curcumin, specifically its low stability and limited bioavailability.Here, we review the studies which have been done on synthesized nanofibers containing curcumin, produced by the electrospinning technique, for the purpose of wound healing.

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HDL cholesterol as a predictor for the incidence of lower extremity amputation and wound-related death in patients with diabetic foot ulcers

Cited by 40 publications

References 32 publications

Análise dos fatores de risco relacionados às amputações maiores e menores de membros inferiores em hospital terciário

Análise dos fatores de risco relacionados às amputações maiores e menores de membros inferiores em hospital terciário

Correlation of HDL cholesterol serum and Wagner’s severity level of diabetic foot ulcers

Curcumin nanofibers for the purpose of wound healing

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