Are Thiol/Disulfide and 8-OHdG Levels in the Blood of Patients with Diabetic Foot a Risk Factor for Amputation?

Abstract

Objective

As diabetic patients live longer and there are more effective treatments available, the incidence of diabetes and its complications is increasing. The effects of oxidative stress and antioxidant processes on diabetes behavior, especially diabetic foot, are really direct. The goal of this research is to investigate the effects of oxidative stress and antioxidant mechanism on the outcome of amputation by examining the levels of 8-hydroxy-2′-deoxyguanosine (8-OHdG) and thiol/disulfide in the blood of patients diagnosed with diabetic foot.

Methods

The research consisted of 76 patients with type 2 diabetes with associated diabetic foot, ages 40–65 (51 men, 25 women). Patients with diabetic foot wounds and accompanying peripheral artery disease were not included in the study. After a mean follow-up of 9.6 months, 28 patients resulted in amputation. Between patients who required amputation and those who did not, the levels of 8-OHdG, native thiol, total thiol, disulfide, native thiol/total thiol ratio, disulfide/native thiol ratio, and disulfide/total thiol ratio were compared. Additionally, the age, sex, Wagner stage, and amputation outcome of these 2 patient groups were compared.

Results

The outcomes of amputation in diabetic foot patients were not related to the levels of native thiol, total thiol, disulfide, native thiol/total thiol ratio, disulfide/native thiol ratio, total thiol/disulfide ratio, or 8-OHdG (P > .05). However, patients with diabetic foot who were male, older, and at a more advanced Wagner stage had a higher rate of amputations (P < .05).

Conclusion

Oxidative stress and antioxidant mechanism are effective on diabetes complications. However, since there are many factors affecting the outcome of amputation, they are not directly effective in terms of resulting amputation in patients with diabetic foot ulcer.