Evaluation of the relationship between profilin-1 levels and peripheral artery disease in patients with diabetic foot ulcer

Objectives: Atherosclerotic cardiovascular diseases (ASCVDs) are quite common in individuals with diabetes mellitus (DM) and are a leading cause of death in this population. Peripheral artery disease (PAD), a type of ASCVDs, affects approximately 50% of patients with diabetic foot ulcers (DFUs). Although profilin 1 (Pfn1) is one of the serum biochemical markers studied in the atherosclerotic processes, it has not investigated in patients with DFU. Therefore, we aimed to compare Pfn1 levels in DFU patients with and without PAH and to identify clinical and biochemical factors that might influence Pfn1 levels. Methods: A total of 88 individuals with type 2 DM, 44 with and 44 without concomitant PAH, were prospectively enrolled in our study. The Wagner classification system is used to grade DFUs. Physical examination, Doppler ultrasound and, if available, the results of computed tomography angiography were used to diagnose PAH. Demographic data, clinical findings, routine lipid levels, renal function tests, haemoglobin A1c and Pfn1 levels of all participants were recorded for comparison. Results: The study observed the following characteristics among our participants: 25% had a history of amputation due to DFU, 43.2% had coronary artery disease (CAD), 13.6% had previous cerebrovascular disease (CVD), 59.1% had hypertension (HT), 46.6% had hyperlipidemia (HL) and 64.8% had proteinuria. Pfn1 levels were significantly higher in those with PAH (median, 774 pg/mL; interquartile range, 550-1005) than in those without PAH (median, 314 pg/mL; interquartile range, 280-432) (p<0.001). Pfn1 levels were significantly higher in patients with Wagner stages 4-5 (median, 663 pg/mL; interquartile range, 440-1073) than in those with Wagner stages 1-3 (median, 419 pg/mL; interquartile range, 286-719) (p=0.002). Pfn1 levels were significantly higher in individuals with a history of amputation due to DFU, CAD and CVD (p=0.009, p=0.011 and p=0.029, respectively). Pfn1 levels were also significantly higher in active smokers compared to non-smokers (p=0.024). XI Conclusions: Significantly higher Pfn1 levels in patients with proven atherosclerotic disease compared to those without in our study suggested that Pfn1 may have an important role in the atherosclerotic process in patients with DFU. Keywords: Profilin 1, diabetic foot ulcer, peripheral artery disease, atherosclerosis