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To observe the correlation between the main components of advanced glycation end products Nε-carboxymethyl-Lysine(CML) and the calcification of the anterior tibial artery plaque in patients with diabetic foot amputation.
Sixty patients hospitalized for diabetic foot amputation in the Department of Orthopedics, Affiliated Hospital of Jiangsu University were recruited from June 2012 to June 2016. The patients were categorized based on the severity of anterior tibial artery stenosis assessed by color Doppler ultrasound, into mild stenosis (0% < stenosis < 50%, n = 20), moderate stenosis (50 ≤ stenosis < 70%, n = 20) and severe stenosis (70 ≤ stenosis ≤ 100%, n = 20). The baseline clinical data of patients were collected and anterior tibial artery was isolated. Then, HE staining, O-Cresolphthalein Complexone method, enzymic method and ELASA analysis were then performed to detect the evolution of calcification, arterial calcium content, alkaline phosphatase activity and serum CML concentration, respectively.
1. The results from both color Doppler ultrasound scan before amputation and HE staining after amputation showed that spotty blue calcium particles of anterior tibial artery plaque, as well as echo intensity, increased significantly and even destructed the elastic plate of the arterial wall with the aggravation of stenosis. 2. Quantitative analysis showed that the content of calcium, ALP activity and serum CML level in anterior tibial artery showed a significant upregulation trend with the aggravation of stenosis-- mild stenosis group vs moderate stenosis group vs severe stenosis group: the content of calcium (2.3±0.9 μmol/mg vs 3.9±1.3 μmol/mg vs 6.6±1.7 μmol/mg, P<0.001), ALP activity (102.4±39.4 U/mg vs 202.3± 73.4 U/mg vs 483.7±117.9 U/mg, P<0.001) and serum CML level (28.9±4.4 ng/mL vs 37.9±5.3ng/mL vs 57.3±7.1 ng/mL, P<0.001). Pearson correlation analysis showed that serum CML level was positively associated with the content of calcium (r=0.749, P<0.0001) and ALP activity (r=0.923, P<0.0001), respectively.
Serum CML level may be related with the calcification of anterior tibial arterial plaque in patients with diabetic amputation.