Raised serum 25-hydroxyvitamin D levels in patients with active diabetic foot ulcers

Afarideh, Mohsen; Ghanbari, P; Noshad, Sina; Ghajar, Alireza; Nakhjavani, Manouchehr; Esteghamati, Alireza

doi:10.1017/s0007114516001094

Cited by 37 publications

(58 citation statements)

References 35 publications

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“…Between 1990 and 2010, US oversaw consistent decreases in all five sentinel indicators of diabetes-related morbidity and mortality, namely myocardial infarction, hyperglycemia crisis, amputation, end-stage renal disease, and stroke 40 . Data on the prevalence of diabetic foot among Iranian patients with diabetes is noticeably scarce 13 , 41 , with two population-based samples of patients with T2D reporting frequencies of 0.7% and 4.0% 28 , 42 . A high frequency of diabetic foot in the NPPCD-2016 survey (6.2%) reflects the highest global prevalence of diabetic foot in MENA (8.6%) as a global diabetes hotspot 43 .…”

Section: Discussionmentioning

confidence: 99%

Diabetes in Iran: Prospective Analysis from First Nationwide Diabetes Report of National Program for Prevention and Control of Diabetes (NPPCD-2016)

Esteghamati

Larijani

Aghajani

et al. 2017

Sci Rep

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248

201

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We estimated proportions of different types of diabetes, comorbidities, treatment (the use of oral glucose-lowering agents and insulin), control (hyperglycemia, dyslipidemia and hypertension) and chronic microvascular and macrovascular complications among people with diabetes presenting to the tertiary-care academic diabetes outpatient clinics in Iran. This study is the prospective analysis of data (n = 30,202) from the registry of university-affiliated adult outpatient diabetes clinics in the country during 2015–2016. The proportions of type 1 diabetes, types 2 diabetes, and other types of diabetes were 11.4%, 85.5%, and 1.3%, respectively. The frequencies of drug-naivety, use of oral agents, insulin monotherapy and insulin combination therapy were 2.9%, 60.5%, 11.5%, and 25.1%, respectively. Around 13.2%, 11.9% and 43.3% of patients with diabetes had controlled hyperglycemia, hyperlipidemia and hypertension, respectively. The proportions of retinopathy, nephropathy, peripheral neuropathy, diabetic foot, and ischemic heart disease were 21.9%, 17.6%, 28.0%, 6.2%, and 23.9%, respectively. Despite the wide availability of medications and insulin coverage in Iran, the estimated national control of hyperglycemia, hyperlipidemia and hypertension (especially for young men and old women) remains subpar. The present study further suggests that the frequencies of chronic vascular complications among patients with diabetes are relatively high in Iran.

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Section: Discussionmentioning

confidence: 99%

Diabetes in Iran: Prospective Analysis from First Nationwide Diabetes Report of National Program for Prevention and Control of Diabetes (NPPCD-2016)

Esteghamati

Larijani

Aghajani

et al. 2017

Sci Rep

Self Cite

248

201

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“…A priori power analysis using data from previous research involving 25(OH)D (24) was conducted to determine the required number of participants (n). Subsequently, the study sample size was calculated using the equations from Whitley & Ball (25) .…”

Section: Sample Size Determinationmentioning

confidence: 99%

Impact of serum 25-hydroxyvitamin D on cardiac prognosis in Chinese patients with heart failure

2019

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There is growing evidence that suggests the association of vitamin D status with the development and progression of heart failure (HF). The objective of the present study is to assess the impact of concentration of serum 25-hydroxyvitamin D (25(OH)D) on cardiac prognosis in patients with HF. Between 1 January 2015 and 31 December 2016, we consecutively recruited patients with HF. Patients were followed prospectively for a median duration of 1 year. Serum concentration of 25(OH)D was measured with competitive chemiluminescent immunoassay. The endpoints were cardiac events, including CVD death and rehospitalisation for worsening HF. Univariate and multivariable adjustments were performed with Cox proportional-hazard regression analyses. The 25(OH)D concentration was obtained in 343 patients with a median value of 17·4 (interquartile range 12·6–23·4) ng/ml. There were 102 cardiac events, including forty-three deaths and fifty-nine rehospitalisations. Multivariate Cox hazard analysis found that the serum concentration 25(OH)D was independently associated with cardiac events (hazard ratio 0·93, 95 % CI 0·88, 0·97) and CVD mortality (hazard ratio 0·83; 95 % CI 0·77, 0·89) after adjustment for confounding factors. We divided the HF patients into four groups according to the 25(OH)D quartiles. Kaplan–Meier analysis found that the patients with lower serum 25(OH)D concentration had a higher risk of cardiac events or CVD mortality than those with high serum 25(OH)D concentration (log-rank test P < 0·001 and P = 0·032). Decreased serum concentrations of 25(OH)D were associated with cardiac prognosis and CVD mortality in a Chinese population with HF independent of other baseline HF markers.

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“…Therefore, this study highlights netrin-1 as a potentially promising agent for wound healing of diabetic vascular complications, including DFU. Emerging studies have verified the critical role of augmented inflammatory response in the pathological process of diabetic vascular complications (Tuttolomondo et al 2015, Afarideh et al 2016, Wu & Chen 2016. Recently, several studies have corroborated that netrin-1 exerts the critical roles in the progression of inflammatory diseases (Podjaski et al 2015, Mediero et al 2016.…”

Section: Discussionmentioning

confidence: 92%

Netrin-1 restores cell injury and impaired angiogenesis in vascular endothelial cells upon high glucose by PI3K/AKT-eNOS

Xing

Lai

Liu

et al. 2017

Journal of Molecular Endocrinology

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Diabetic foot ulceration (DFU) represents a common vascular complication of diabetes mellitus (DM) with high morbidity and disability resulting from amputation. Netrin-1 level was decreased in type 2 DM patients and has been identified as a protective regulator against diabetes-triggered myocardial infarction and nephropathy. Unfortunately, its role and molecular mechanism in DFU remain poorly elucidated. Here, netrin-1 levels were reduced in DM and DFU patients relative to healthy controls, with netrin-1 levels being the lowest in DFU patients. Moreover, exposure to high glucose (HG) also suppressed netrin-1 expression in human umbilical vein endothelial cells (HUVECs). Elevated netrin-1 expression by infection with Ad-netrin-1 adenovirus vector protected against HUVEC injury in response to HG by ameliorating the inhibitory effects on cell viability, lactate dehydrogenase (LDH) and malondialdehyde (MDA) levels, cell apoptotic rate and caspase-3 activity. Importantly, HG-impaired angiogenesis was improved after netrin-1 overexpression by elevating cell migration, capillary-like tube formation and VEGF production. Mechanism assay substantiated that netrin-1 elevation increased the phosphorylation levels of AKT and eNOS, and NO production, which was notably suppressed by HG, indicating that netrin-1 overexpression restored HG-triggered impairment of the PI3K/AKT-eNOS pathway. More intriguingly, preconditioning with LY294002 (PI3K/AKT antagonist) or -monomethyl-l-arginine (eNOS inhibitor) antagonized netrin-1-induced activation of the PI3K/AKT-eNOS pathway. Concomitantly, treatment with these antagonists also attenuated the protective role of netrin-1 in endothelial dysfunction upon HG stimulation. These results suggest that elevation of netrin-1 may restore HG-triggered impairment of HUVEC and angiogenesis by activating the PI3K/AKT-eNOS pathway, indicating a potential agent for wound healing in DFU patients.

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Raised serum 25-hydroxyvitamin D levels in patients with active diabetic foot ulcers

Cited by 37 publications

References 35 publications

Diabetes in Iran: Prospective Analysis from First Nationwide Diabetes Report of National Program for Prevention and Control of Diabetes (NPPCD-2016)

Diabetes in Iran: Prospective Analysis from First Nationwide Diabetes Report of National Program for Prevention and Control of Diabetes (NPPCD-2016)

Impact of serum 25-hydroxyvitamin D on cardiac prognosis in Chinese patients with heart failure

Netrin-1 restores cell injury and impaired angiogenesis in vascular endothelial cells upon high glucose by PI3K/AKT-eNOS

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