LIPID PROFILE CHARACTERISTICS IN PATIENTS WITH VENOUS LEG ULCERS DEPENDING ON THE PRESENCE AND DEGREE OF GLYCEMIC CONTROL IN TYPE 2 DIABETES MELLITUS
DOI:
https://doi.org/10.11603/mcch.2410-681X.2026.i3.16737Keywords:
venous leg ulcer; chronic venous insufficiency; type 2 diabetes mellitus; diabetic dyslipidemia; lipid profile; low-density lipoprotein cholesterol; high-density lipoprotein cholesterol; triglycerides; non-high-density lipoprotein cholesterolAbstract
Background. Venous leg ulcers represent the most severe manifestation of chronic venous insufficiency and are characterized by prolonged healing and a high recurrence rate. Type 2 diabetes mellitus (T2DM) substantially worsens the clinical course of venous ulcers through persistent hyperglycemia, endothelial dysfunction, microvascular impairment, and chronic inflammation. Diabetic dyslipidemia, characterized by elevated levels of triglycerides, low-density lipoprotein cholesterol (LDL-C), and non-high-density lipoprotein cholesterol (non- HDL-C), together with reduced high-density lipoprotein cholesterol (HDL-C), may further contribute to impaired tissue repair and unfavorable clinical outcomes. Objective. To evaluate lipid profile characteristics in patients with venous leg ulcers depending on the presence of type 2 diabetes mellitus and the degree of glycemic control. Materials and Methods. The study included 300 patients with chronic venous leg ulcers (CEAP clinical class C6). Group 1 comprised 104 patients without diabetes mellitus, Group 2 included 98 patients with compensated T2DM, and Group 3 consisted of 98 patients with decompensated T2DM. Serum total cholesterol, LDL-C, HDL-C, triglycerides, non-HDL-C, and the atherogenic coefficient were determined after overnight fasting. Statistical analysis was performed using one-way analysis of variance (ANOVA) followed by Bonferroni post hoc testing. Differences were considered statistically significant at p < 0.05. Results. Patients with decompensated T2DM demonstrated significantly higher levels of total cholesterol (6.42 ± 1.18 mmol/L), LDL-C (4.32 ± 0.94 mmol/L), triglycerides (2.94 ± 1.08 mmol/L), non-HDL-C (5.58 ± 1.21 mmol/L), and the atherogenic coefficient (6.64 ± 1.94), together with significantly lower HDL-C concentrations (0.84 ± 0.24 mmol/L), compared with patients without diabetes and those with compensated T2DM (all p < 0.001). Progressive deterioration of lipid metabolism closely paralleled worsening glycemic control. None of the patients with decompensated diabetes achieved the recommended LDL-C target for individuals at very high cardiovascular risk. Conclusions. The severity of lipid metabolism disorders in patients with venous leg ulcers is closely associated with the degree of glycemic control in type 2 diabetes mellitus. Decompensated diabetes is accompanied by pronounced diabetic dyslipidemia, which may contribute to endothelial dysfunction, impaired microcirculation, delayed wound healing, and progression of chronic venous insufficiency. Comprehensive assessment of the lipid profile, including non-HDL cholesterol and the atherogenic coefficient, should be considered an important component of the clinical evaluation of patients with venous leg ulcers and T2DM.
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