The relationship between osteoprotegerin levels vascular calcification and severity of disease in patients with diabetic foot ulcer

Aim: Diabetic foot ulcer is one of the most important public health problems due to reasons such as length of hospital stay, cost, mortality and high morbidity. Osteoprotegerin (OPG) is a glycoprotein of the tumor necrosis factor receptor superfamily that is secreted from many tissues, including bone and endothelial and smooth muscle cells. This study aims to investigate the effect of OPG on arterial calcification and severity of the disease in patients with diabetic foot injury. Material and Method: In this study, 30 patients with diabetic foot ulcer, 27 diabetic patients with no diabetic foot ulcer and 28 control group adults admitted to our hospital Endocrine Clinic were included. The OPG gene was were measured in the serum samples taken from the patients using ELISA kits and at the same time, patients' HbA1c, lipid panel, CRP(c-reactive protein), hemogram, BUN(Blood Urea Nitrogen), creatinine, ALT(alanineaminotransferase), 25-OH-VITD3, calcium, inorganic phosphorus and the ratio of protein to creatinine were measured in spot urine, simultaneously. Additionally, the patients' anemnesis demographic information, weight, back ground information, presence of additional disease, type and duration of DM, drugs used, smoking/alcohol use status, microvascular/macrovascular complications were recorded. Ca score (Calcium score) was also calculated by foot/ankle multislice CT to assess arterial calcification. Results: Microvascular/macrovascular complications were revealed higher in patients with diabetic foot ulcer compared to the controls. There was a significant relationship between OPG levels and the presence of coronary artery disease, drug use and CRP levels of patients with diabetic foot ulcer. Conclusion: The relationship between OPG level and lower extremity Ca score was determined significantly higher in patients with diabetic foot ulcer compared to the controls without foot ulcer. However, the relationship between the Wagner classification used for evaluating the severity of the disease and the OPG level and Ca score was not found statistically significant. Keywords: Diabeticfoot, Osteoprotegerin, Vascular calcification