USU Conference Systems, International Conference on Tropical Medicine and Infectious Diseases (ICTROMI) 2017

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Association of Fibrinogen with HbA1C and Wagner’s Classification in Diabetic Foot Ulcer
aron pase

Last modified: 2017-10-27


Fibrinogen is one of the effective inflammatory markers for vascular changes and endothelial dysfunction in diabetic patients. The aim of this study is to estimate the serum fibrinogen levels in diabetic foot ulcer (DFU) and to find its association with HbA1C, grading of Wagner’s classification and Ancle Brachial Index (ABI). The study was designed as a restropective  analytical cross-sectional study, carried out in H Adam Malik Central General Hospital. The study population included inpatients from the internal medicine ward from January to July 2017. In total, there were 33 DFU patients enrolled in the study, who also had diabetic foot ulcer as well. The data included the patients’ demographic infromation, history of ilness, clinical examination and routine laboratory assays. The grading of DFU was evaluated according to the Wagner’s Classification. Another tests for evaluation of serum fibrinogen level, HbA1C and ABI were carried out directly to the patients after signing informed consent under the approval of the Committee of Ethics, Faculty of Medicine, Universitas Sumatera Utara. The mean age of the study population was 52,58 + 7,75 years . The mean value of fibrinogen serum levels found in the study was 436.55 + 222.28 mg/dl. According to Wagner’s classification the most common grading of DFU found was grade 4 (48,5%), followed by grade 3 (39.4%) and grade 5 (9.1%). HbA1C, mean + SD, % (9.72 + 2.63). There were 69,7% (n=23) of the total study population showing poor glycemic control (HbA1C).There was a significant positive correlation between fibrinogen serum levels and HbA1C (r=0.387;P= 0,026). Fibrinogen serum levels were significantly higher in patients with HbA1C > 9 compared to those with HbA1C <7 (P=0.001), and in patients with Wagner’s Classification Grade 5 compared to than with grade 3 and 4 (<0.001). Meanwhile, there was a significant negative correlation found between fibrinogen serum levels and ABI in patients with DFU (r= -0.454;P=0.008). In conclusion, fibrinogen serum levels in DFU patients were positively correlated with HbA1C and significantly higher in patients with poor glycemic control.

Keywords: Fibrinogen, diabetic foot ulcer, glycemic control