{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T09:01:16Z","timestamp":1777712476352,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T00:00:00Z","timestamp":1745712000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100018998","name":"Ege University Research Foundation","doi-asserted-by":"publisher","award":["TTU-2020-21555"],"award-info":[{"award-number":["TTU-2020-21555"]}],"id":[{"id":"10.13039\/501100018998","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The International Journal of Lower Extremity Wounds"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>Diabetic foot (DF) is a significant complication with high morbidity and mortality, often resulting from neuropathy and ischemia. In our study, we aimed to evaluate the relationship between serum Gremlin-1 levels and disease severity based on the Wagner classification in DF patients, and to determine its prognostic value in predicting the need for amputation.<\/jats:p>\n                  <jats:p>Eighty-five patients with DF ulcers or considered at high risk for DF were included in the study. The patients\u2019 complications were evaluated, and laboratory results were obtained from their records. The Wagner classification was applied, and serum Gremlin-1 levels were analyzed using the ELISA method.<\/jats:p>\n                  <jats:p>It was found that as the Wagner stage of the DF increased, Gremlin-1 levels decreased significantly at the statistical borderline (p\u2009=\u20090.05). In the group of patients who underwent amputation, Gremlin-1 levels decreased significantly (p\u2009&lt;\u20090.05). The sensitivity of Gremlin-1 in predicting amputation, with a cut-off value of 2.47 ng\/ml, was 67%, and its specificity was 46%. Additionally, a positive correlation was found between total cholesterol, LDL, fasting glucose, and Gremlin-1 (p\u2009&lt;\u20090.05). In the group of patients with an HbA1c value &gt;7.5%, Gremlin-1 levels increased significantly (p\u2009&lt;\u20090.05). In patients with albuminuria, serum Gremlin-1 levels decreased significantly (p\u2009&lt;\u20090.05).<\/jats:p>\n                  <jats:p>It was determined that Gremlin-1 plays a role through an unknown mechanism in DF patients, and its levels decrease as the Wagner stage increases. Gremlin-1 levels were significantly decreased in the amputation group (p\u2009&lt;\u20090.05). It was shown that Gremlin-1 could be a prognostic marker for predicting amputation.<\/jats:p>","DOI":"10.1177\/15347346251337157","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T02:42:26Z","timestamp":1745808146000},"page":"577-585","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Gremlin-1 and Wagner Classification: Potential Biomarker for Amputation in Diabetic Foot Patients"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5956-6979","authenticated-orcid":false,"given":"\u015eeyma","family":"A\u00e7\u0131k","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolic Diseases, Antalya Training and Research Hospital, Antalya, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u015eevki","family":"\u00c7etinkalp","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolic Diseases, Ege University Faculty of Medicine, Izmir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5194-1746","authenticated-orcid":false,"given":"\u00c7i\u011fdem G\u00f6zde","family":"Aslan","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Biruni University Faculty of Medicine, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasemin","family":"Ak\u00e7ay","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Ege University Faculty of Medicine, Izmir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,4,27]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/88.11.1436"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12475"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67698-2"},{"issue":"2","key":"e_1_3_3_5_2","first-page":"26","article-title":"The Journal of Diabetic Foot Complications Diabetic Foot Infections: Current Diagnosis and Treatment","volume":"4","author":"Mendes JJ","year":"2012","unstructured":"Mendes JJ, Neves J. The Journal of Diabetic Foot Complications Diabetic Foot Infections: Current Diagnosis and Treatment. J Diabetic Foot Complicat. 2012;4(2):26-45.","journal-title":"J Diabetic Foot Complicat"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1574-695X.1999.tb01397.x"},{"issue":"1","key":"e_1_3_3_7_2","first-page":"858206","article-title":"Determinants of microbial load in infected diabetic foot ulcers: A pilot study","volume":"2013","author":"Demetriou M","year":"2013","unstructured":"Demetriou M, Papanas N, Panopoulou M, Papatheodorou K, Maltezos E. Determinants of microbial load in infected diabetic foot ulcers: A pilot study. Int J Endocrinol. 2013;2013:(1):858206. https:\/\/doi.org\/10.1155\/2013\/858206","journal-title":"Int J Endocrinol"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00508-014-0630-5"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1128\/MCB.21.2.636-643.2001"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/pro.2485"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1042\/BJ20100305"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcb.2010.01.008"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.2337\/db19-0701"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2006.092460"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200706-945OC"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1210\/en.2008-0090"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/nm888"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1242\/dev.01251"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2005.03.014"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-6-74"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M600711200"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-06-291930"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-023-01880-x"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2018.05.007"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.14310\/horm.2002.1245"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.2337\/db14-1127"},{"issue":"1","key":"e_1_3_3_27_2","first-page":"2358321","article-title":"Fibrinogen: A marker in predicting diabetic foot ulcer severity","volume":"2016","author":"Li XH","year":"2016","unstructured":"Li XH, Guan LY, Lin HY, et al. Fibrinogen: A marker in predicting diabetic foot ulcer severity. J Diabetes Res. 2016;2016(1):2358321. https:\/\/doi.org\/10.1155\/2016\/2358321","journal-title":"J Diabetes Res"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2010.08.002"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S372146"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.14814\/phy2.12010"}],"container-title":["The International Journal of Lower Extremity Wounds"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15347346251337157","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15347346251337157","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15347346251337157","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:05:30Z","timestamp":1777457130000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15347346251337157"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,27]]},"references-count":29,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1177\/15347346251337157"],"URL":"https:\/\/doi.org\/10.1177\/15347346251337157","relation":{},"ISSN":["1534-7346","1552-6941"],"issn-type":[{"value":"1534-7346","type":"print"},{"value":"1552-6941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,27]]}}}