Wang C L, Wang M, Lin M C, Chien K L, Huang Y C, Lee Y T
Department of Orthopedic Surgery, College of Medicine, National Taiwan University, Taipei.
J Formos Med Assoc. 2000 Jan;99(1):5-10.
This comparative cross-sectional and community-based study was aimed at defining foot complications in diabetic patients. These data have not yet been reported for Asian societies.
Of a population of 3,602 subjects aged 35 years or more in Chin-Shan, Taipei, 309 diabetic patients were identified. Two hundred and nineteen (71%) of those patients were compared to 100 individuals randomly selected for the nondiabetic control group in the same community.
Three diabetic patients underwent lower extremity amputation and four had skin ulcerations. Diabetic patients had a significantly higher prevalence of peripheral neuropathy (32.4% vs 16%), arterial insufficiency (12.6% vs 3.0%), and medial arterial calcification (13.6% vs 5.0%), when compared to the nondiabetic controls. The age and sex-adjusted rates of hallux valgus, loss of skin hair on the dorsum of the foot, tinea unguium, arterial insufficiency, medial artery calcification, and peripheral neuropathy were significantly higher in diabetic than nondiabetic subjects. Aging and hyperglycemia (> 140 mg/dL) increased the prevalence of foot complications in both groups. Foot complications were also remarkably associated with the duration of diabetes (p = 0.003).
This study shows that diabetes mellitus is associated with an increased likelihood of foot complications in this geographically defined Taiwanese population. Patient age and diabetic duration are associated with the significantly higher prevalence of foot complications.
本项基于社区的比较性横断面研究旨在明确糖尿病患者的足部并发症情况。亚洲社会尚未有此类数据报道。
在台北金山3602名35岁及以上的受试者中，识别出309名糖尿病患者。将其中219名患者（71%）与在同一社区随机选取的100名非糖尿病对照组个体进行比较。
3名糖尿病患者接受了下肢截肢手术，4名出现皮肤溃疡。与非糖尿病对照组相比，糖尿病患者外周神经病变（32.4%对16%）、动脉供血不足（12.6%对3.0%）和动脉中层钙化（13.6%对5.0%）的患病率显著更高。在年龄和性别调整后，糖尿病患者拇外翻、足背皮肤毛发缺失、甲癣、动脉供血不足、动脉中层钙化和外周神经病变的发生率显著高于非糖尿病受试者。年龄增长和高血糖（>140mg/dL）使两组足部并发症的患病率均增加。足部并发症也与糖尿病病程显著相关（p = 0.003）。
本研究表明，在这个特定地理区域的台湾人群中，糖尿病与足部并发症发生可能性增加相关。患者年龄和糖尿病病程与足部并发症患病率显著更高相关。
