Endothelial fluctuation amplitude of microcirculation in carriers of different polymorphic markers C786T of the eNOS gene and Lys198Asn of the END1 gene with diabetic foot syndrome

Abstract

Aim: To study the microcirculatory endothelial fluctuation amplitude in carriers of various polymorphic markers C786T of the eNOS gene and Lys198Asn of the END1 gene with diabetic foot syndrome.

Materials and methods: The study included 198 patients with uncomplicated diabetes mellitus and 199 patients with diabetic foot syndrome. The distribution of genotypes of polymorphic markers C786T of the eNOS gene and Lys198Asn of the END1 gene was evaluated by the polymerase chain reaction. Microvasculature was examined at three points using laser Doppler flowmetry in 30 people of each group comparable by the distribution of the studied gene polymorphisms,. The endothelial rhythm amplitude (Ae) of microcirculation was assessed.

Results: At the point on the 1^st toe plantar surface, the Ae was 66% lower in patients with the C/C genotype of the eNOS gene C786T polymorphism and diabetic foot syndrome compared to uncomplicated diabetic patients with the C/C genotype. The eNOS gene C/T polymorphism C786T was associated with a 57% decrease in the Ae value at this point. No changes were observed in patients with diabetic foot syndrome at points on the lower third of the forearm and on the back of the foot in the 1st intermetatarsal space. For the Lys/Lys and Asn/Asn genotype variants of the END1 gene Lys198Asn polymorphism in presence of diabetic foot, the Ae values at the forearm point were 38% and 36% lower than in uncomplicated diabetes mellitus, respectively. There were no differences between patients with diabetic foot syndrome and patients with uncomplicated diabetes mellitus at the points on the dorsal and the plantar surfaces of the 1st toe.

Conclusion. These results may indicate the presence of genetically determined changes in the microcirculatory bed at the level of systemic and local microcirculation in diabetic foot syndrome. In addition, the results of this study suggest that mechanisms of microcirculatory disorders may be involved through different pathways, which may be important for the pathogenesis of this diabetic complication.