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The association between hypoxia-inducible factor 1α tissue concentration and the risk of amputation in diabetic foot ulcer patients


Background: Diabetic foot ulcer (DFU) is one of the complications of diabetes mellitus, with a high rate of disability and mortality. Amputation is the last option for DFU management with a poor healing prognosis; moreover, angiogenesis plays an important role in wound healing. HIF-1α is a key player in neovascularization and tissue formation. The present study aimed to investigate the role of HIF-1α in predicting the risk of amputation in DFU patients.

Methods: This study was a cross-sectional study conducted from June 2019-December 2020. Subjects were DFU patients indicated for amputation or debridement. The tissue sample was collected from the proximal side of the wound. The concentration of HIF-1α was calculated using the ELISA sandwich method. The multiple logistic regression was used to determine the independent risk of each patient's characteristic and HIF-1α in amputation.

Results: A total of 67 DFU patients were enrolled:  31 amputations and 36 debridements. HIF-1α concentration in the amputation was lower than in the debridement group (median: 5.77 versus 26.56, p<0.001). The cut-off of HIF-1α concentration is 8.807 pg/mg protein. Patients with HIF-1α concentration <8.807 pg/mg had a higher risk of amputation than those with HIF-1α concentration ≥8.807 pg/mg (OR 11.12, 95% CI 1.44–85.75).

Conclusion: HIF-1α has a significant role in predicting amputation in DFU patients.


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How to Cite

Darwis, P., Yunir, E., Kekalih, A., Muradi, A., Jusman, S. W., Yuwono, H. S., & Purnomo, S. H. (2022). The association between hypoxia-inducible factor 1α tissue concentration and the risk of amputation in diabetic foot ulcer patients. Bali Medical Journal, 11(2), 1067–1070.




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