ABSTRACT
Objectives: To study plasma homocysteine and lipoprotein [a] levels together with sum other conventional tisk factors for atherosclerosis in diabetic foot ulcer [DFU] patients in comparism to diabetic palicnts without foot ulceration
Subjects and Methods: The study included 66 patients with type 2 diabetes [37 with DFU and 29 without DFU] and 20 healthy normal subjects of matched age and sex. DFU patients were classified into neuropathic, ischemic or neuroischemic ulcer according to neuropathy disability score. Plasma levels of total homocysteine [tHcy] was measured by enzyme immunoassay while lipoprotein [a] was measured by immunoturbidimetric method. Serum folic acid and vitamin BIZ were measured by radioimmunoassay
Results: Fasting plasma homocysteine and lipoprotein [a] levels were elevated in diabetic patients compared to the control subjects. DFU patients had significantly higher levels of tHcy and Lp[a] in comparison to non-DFU patients. Serum folate was lower in diabetic patients in comparison to the control subjects. DFU patients had significantly lower levels of folic acid in comparison to non-DFU patients. Serum levels of vitamin BIZ showed non significant changes in DFU, non-DFU and control subjects. Urinary albumin excretion [UAE] was significantly higher in the DFU patients in comparison to non-DFU patients. Homocysteine concentration showed significant positive correlation with UAE and Lp[a] and significant negative correlation with serum folic acid
Conclusion: DFU patients had higher levels of homocysteine and lipoprotein [a] and lower levels of folic acid in comparison to diabetic patients without DFU. Hyperhomocysteinemia and hyperlipoproteinemia [a] may partially explain the increased risk of macrovascular complications in DFU patients