ASSESSMENT OF HYDROXYPROLINE LEVELS IN NON-ISCHEMIC DIABETIC FOOT ULCERS DURING RECOVERY. A PROSPECTIVE CASE-CONTROL STUDY

Abstract

Background and aims: Proline hydroxylation is essential for collagen synthesis in wound healing. Therefore, hydroxyproline quantification may be a suitable marker of wound healing in diabetic tissue. Material and method: This is a prospective case- control clinical study including 90 referral patients from our clinics in Golestan hospital affiliated to Jundishapour Medical University, Ahwaz-Iran, during a period of 18 months. Three groups were recruited: intervening diabetics with non-ischemic foot ulcers, diabetics without foot ulcers (normal diabetics) and non-diabetics without foot ulcers (normal non-diabetics) as control groups (n=30 per group). 500 mg of granulation tissue from ulcers after treatment and 500 mg of normal skin from both control groups were taken for the measurement of hydroxyproline levels. Results: 13 (43.3%) males and 17 (56.7%) females in trial group were analysed. There was no significant differences in age, gender, and BMI between groups. Mean hydroxyproline concentration in wound granulation tissue (140.44 μg/g) was statistically different from the mean concentration in the skin content of normal diabetics (173.22 g/g,) and the skin content of non- diabetics (178.83 μg/g) (p=0.001). There were no statistically significant differences between the mean values of normal diabetics and non-diabetics (p=0.63). Conclusion: Our results showed the presence of a lower quantity of hydroxyproline in diabetic patients with foot ulcers compared to control groups. This raises the issue of its effectiveness in delaying the repair process in diabetics. Therefore, compensating for tissue hydroxyproline deficit can be a clue in improving diabetic tissue repair.