Exploring The Role of Serum Netrin 1 Levels in Diabetic Foot Syndrome And Uncomplicated Type 2 Diabetes Mellitus: A Comparative Analysis.

Abstract

Purpose: Serum netrin levels have been implicated in diabetes and its complications, including diabetic foot syndrome. Netrin 1, a protein encoded by the Netrin gene, has been recognized for its role in various physiological processes ranging from nervous system development to angiogenesis, inflammation, and wound healing. In the context of diabetes, there is growing interest in understanding the relationship between serum netrin levels and the disease. Studies have suggested that netrin-1 may have a role in angiogenesis and inflammatory responses, both of which are relevant to diabetes and its complications. Research has indicated that may be involved in the pathophysiology of diabetic foot syndrome, a serious complication of diabetes characterized by issues such as foot ulcers and impaired wound healing. Therefore, comparing serum netrin levels in individuals with diabetes, especially those with complications like diabetic foot syndrome, to those with uncomplicated diabetes, may provide insights into the potential association between netrin and the disease.

Methodology: Eligible patients were recruited, and two ml of venous blood samples were collected from each patient Netrin-1 levels were estimated using an ELISA method from the blood sample collected in a plain vial.

Objective: To assess and compare the levels of serum netrin in individuals diagnosed with diabetic foot syndrome and those with uncomplicated Type 2 diabetes mellitus.

Results: Logistic regression identified gender, BMI, smoking, LDL, and Netrin 1 (NTN1) levels as predictors of diabetic foot, with males and smokers at higher risk, BMI showing a protective effect, and NTN1 indicating a potential protective role. Clinical presentations included cellulitis, ulcers, and gangrene. A weak positive correlation was observed between fasting blood sugar (FBS) and NTN1 levels (r = 0.1106), with no significant differences in NTN1 across diabetic foot grades (p = 0.435). ROC analysis of NTN1 levels (cutoff 140.0 pg/ml) showed moderate diagnostic utility (65.4% sensitivity, 60% specificity, AUC 0.577), suggesting its potential as a biomarker.

Conclusion: The study findings unveiled that individual with diabetic foot syndrome (DFS) exhibited elevated serum Netrin-1 levels when compared to those with uncomplicated Type 2 diabetes (T2DM). These results emphasized the significance of Netrin-1 within the diabetic foot syndrome context and offered valuable guidance for forthcoming investigations into its role in angiogenesis, inflammation, and wound healing processes.