Endothelial And Extracellular Matrix Biomarkers In Diabetic Foot Disease Among Patients With Type 2 Diabetes Mellitus
Keywords:
Type 2 diabetes mellitus, biomarkers, diabetic foot disease, VCAM-1Abstract
Type 2 diabetes mellitus (T2DM) remains a major cause of chronic vascular disease and disability, and delayed diagnosis often means the condition is first recognized after complications have developed. Diabetic foot syndrome (DFS) is one of the most severe T2DM complications, arising from ischemia, neuropathy, and chronic inflammation and leading to ulceration, prolonged treatment, and a high risk of amputation. To determine the pattern and magnitude of changes in serum sVCAM-1 and MMP-9 levels in patients with T2DM depending on the presence of DFS. The study enrolled 58 men and women aged 50–65 years with T2DM, divided into an uncomplicated T2DM group (n=30) and a T2DM+DFS group (n=28); 26 age- and sex-matched apparently healthy individuals served as controls. Serum sVCAM-1 and MMP-9 were measured by ELISA using certified kits, and between-group differences were assessed with p<0.05 considered statistically significant. Serum sVCAM-1 was significantly elevated in patients with type 2 diabetes mellitus compared with controls and increased further in those with diabetic foot syndrome (p < 0,001). Serum MMP-9 showed the same pattern, being significantly higher in uncomplicated type 2 diabetes than in controls and reaching the highest levels in the diabetic foot group (p < 0,001). Overall, both biomarkers demonstrated a stepwise, statistically significant rise from controls to uncomplicated diabetes and to diabetes complicated by diabetic foot syndrome, consistent with more pronounced endothelial activation and inflammation-associated proteolytic remodeling in DFS.
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