Heat-shock protein 70 gene polymorphism is associated with the severity of diabetic foot ulcer and the outcome of surgical treatment.
BACKGROUND
Foot ulcer is a significant cause of morbidity in diabetics. Genetic make-up can determine inflammatory and healing responses. This study examined the hypothesis that specific polymorphisms of the heat-shock protein 70 gene could predispose to the severity of diabetic foot ulceration.


METHODS
Some 106 consecutive diabetic patients (101 evaluable) with foot ulceration admitted to a tertiary care hospital were managed according to a standard protocol. DNA was extracted from venous blood and examined by polymerase chain reaction-restriction fragment length analysis for two specific polymorphisms: G1538A in the HSPA1B and C2437T in the HSPA1L gene.


RESULTS
HSPA1B genotyping showed that 70 patients were AG and 30 GG (one not amplified). The AG genotype was significantly associated with the severity of foot ulceration (Wagner grade) (P = 0.008, chi(2) test), need for amputation (relative risk 2.02, 95 per cent confidence interval 1.02 to 4.01; P = 0.025) and median length of hospital stay (8 versus 5 days for GG; P = 0.043). HSPA1L genotypes (78 TT, 22 CT, one CC) did not show any significant association with these parameters.


CONCLUSIONS
The HSPA1B genotype, was associated with the severity of diabetic foot ulceration, need for amputation and duration of hospitalization in these patients.
Mir
K A
KA
Department of Surgical Endocrinology, Christian Medical College, Vellore, India.
Pugazhendhi
S
S
Paul
M J
MJ
Nair
A
A
Ramakrishna
B S
BS
D000368:Aged; D000671:Amputation, Surgical; D017719:Diabetic Foot / Q000235:genetics* / Q000601:surgery; D005260:Female; D005838:Genotype; D018840:HSP70 Heat-Shock Proteins / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D012150:Polymorphism, Restriction Fragment Length / Q000235:genetics*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012720:Severity of Illness Index; D016896:Treatment Outcome
D018840:HSP70 Heat-Shock Proteins; C490786:HSPA1A protein, human; C525621:HSPA1B protein, human