High density lipoprotein (HDL) level may be a risk factor of lower extremities amputation (LEA) in patients with diabetic foot ulcer (DFU).

[摘要] Diabetes related lower extremity amputation (LEA) is associated with high incidence of morbidity andmortality various risk factors of diabetic foot ulcers (DFU). Dyslipidemia including low HDL levels is a major riskfactor of PVD in diabetic patients. The aim of this study was to evaluate HDL cholesterol level as a risk factorand predictor for LEA and major cardiac events (MACE) in patients with DFU. In this study, 112 diabeticpatients had (DFU). The patients were divided into two subgroups: Group (A) which included 55 high-riskpatients with a long history of DFU more than six month duration and group (B) of 57 low-risk patients with ashort history of DFU less than six month duration.Lipid profile including HDL was measured in all patients.Peripheral pulsations, protective sensation and ankle/brachial index (ABI) were also evaluated in bothgroups.All patients were followed for one year for major cardiac events (MACE) and lower extremityamputation.The overall results revealed that HDL was significantly lower (31.47 ± 8.86 mg/dl) in high risk groupcompared to low risk group (36.72 ± 5.45 mg/dl; P< 0.03).Patients of high risk group had a significantly lowerankle pressure (105.72 ± 30.23 mmHg) and ABI (0.77 ± 0.24) compared to low risk group (136.75 ± 33.49mmHg and 1.07 ± 0.22, respectively; P < 0.001).HDL was (31.34 ± 1.91& 40.38 ± 8.26; P< 0.001) for amputatedand non-amputated patients, respectively.MACE were significantly higher in high risk group compared to lowrisk group (69.1% vs. 31.6%; P< 0.001) .Furthermore amputations were significantly more frequent among highrisk patients compared to those with low risk (78.2% vs. 28.1%; P< 0.001).HDL had 100% sensitivity and 91%specificity for prediction of amputation at cutoff point < 35mg/dl with area under the curve was 0.91.Theobserved independent risk factors for lower limb amputation in patients with diabetic foot ulcer were HDL <40 mg/dl (OR= 19.1, 95%CI= 12.9- 34.46; P= 0.01), previous amputation (OR= 4.68, 95%CI= 1.63- 13.44; P=0.01), ankle brachial index (OR= 5.67, 95%CI= 3.45- 12.45; P= 0.03),and sever infection (OR= 17.8, 95%CI=2.13- 18.89; P= 0.01).So, HDL cholesterol level may be an important independent predictor for LEA and MACEin patients with DFU.

[学科分类] 工程和技术（综合）

[关键词] HDL cholesterol;Diabetic foot ulcer;Lower extremity amputation.