THE PREVALENCE OF GENETIC POLYMORPHISMS FOR REGULATION OF VASCULAR TONE, PLATELET RECEPTORS, VASCULAR WALL REMODELING AND PROTHROMBOTIC FACTORS IN DIABETIC FOOT SYNDROME
Authors:   Chita State Medical Academy, Troitskaya N.I. , Shapovalov K.G. ,   Chita State Medical Academy, Mudrov V.A. ,   Chita State Medical Academy
Published: November 2021

Objective. To analyze the frequency of occurrence of eNOS 786C>T, END1 Lys198Ash, ITGB3 1565T>C (Leu33Pro), F5 1691G>A, F2 20210G>A, MMP9 8202A>G, MTHFRA 1298 C,VEGFA 634C>G gene polymorphisms in diabetic foot syndrome. Methods. The study included patients (n=198) with uncomplicated diabetes mellitus and patients (n=199) with the development of diabetic foot syndrome. Genotyping of the studied gene polymorphisms was performed by the polymerase chain reaction method. Results. In patients with uncomplicated diabetes mellitus and in patients with diabetic foot, no significant differences were found in the frequency of occurrence of polymorphisms 786C>T of the eNOS3 gene, Lys198Ash of the END1 gene, 1691G>A of the F5 gene, 20210G>A of the F2 gene, 8202A>G of the MMP9 gene, 634C> G of the VEGFA gene and their allelic variants. Associative relationship between the polymorphisms of the NOS 786C>T, END1 Lys198Ash, F5 1691G>A, F2 20210G>A, MMP9 8202A>G, VEGFA 634C>G genes and the development of diabetic foot syndrome was not found. With the development of a diabetic foot, a heterozygous variant of the 1565TС polymorphism of the ITGB3 gene was more common than in uncomplicated diabetes mellitus (37.7% and 28.3%, respectively (χ²=6.243, p=0.045)). The risk of developing a diabetic foot with the carriage of this polymorphism is 1.5 times higher than with other variants of gene polymorphism ((OR=1.534 (95% Cl 1.006 - 2.338), p<0.05). Polymorphism 1298 AS of the MTHFR gene was more often detected in the group of patients with uncomplicated diabetes mellitus than in the group with the development of diabetic foot (45.4% and 29.1%), (χ²=11.55, p=0.004). Conclusion. The development of diabetic foot syndrome is associated with the carriage of the heterozygous 1565TС polymorphism of the ITGB3 gene, in which the likelihood of developing this complication increases 1.5 fold. In diabetes mellitus without complications, a more frequent carriage of the heterozygous polymorphism 1298 AC of the MTHFR gene was revealed, which may have a protective effect against the development of diabetic foot syndrome. What this paper adds The frequency of occurrence of genetic polymorphisms for regulating vascular tone, platelet receptors, vascular wall remodeling and prothrombotic factors and their allelic variants in diabetic foot syndrome was studied. It was found that the frequency of heterozygous 1565TС polymorphism of the ITGB3 gene in the development of diabetic foot is 1.3 fold higher than in the uncomplicated course of the disease. It was revealed that the fregnency of this variant of the ITGB3 gene polymorphism is associated with the risk of developing this complication of diabetes mellitus. In the presence of the heterozygous 1565TС polymorphism of the ITGB3 gene, the risk of developing diabetic foot syndrome increases by 1.5 fold than with the carriage of other variants of the T1565С polymorphism of the ITGB3 gene. It was found that in the uncomplicated course of the disease, the heterozygous genotype 1298 AC of the MTHFR gene occurs 1.6 fold more often than in the development of diabetic foot syndrome.