Tseng Chin-Hsiao
Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
CMAJ. 2006 Jan 31;174(3):319-23. doi: 10.1503/cmaj.050680.
Taller diabetic patients are at higher risk of peripheral sensory loss than shorter diabetic patients and thus may be at increased risk of lower-extremity ulcers and amputation. In a large telephone survey, the prevalence of lower-extremity amputation among patients with diabetes mellitus was determined and the association between height and lower-extremity amputation evaluated.
Of 256,036 patients identified from hospital and clinic databases who had a diagnosis of diabetes and were seen at those institutions between 1995 and 1998, 128,572 were randomly selected to be interviewed by telephone between 1995 and 2002. Of the 93,484 patients who agreed to be interviewed, 386 were excluded (age < 18 years); this left 93,116 diabetec patients (42,970 men and 50,146 women) for inclusion in the study.
Of the 93,116 patients interviewed, 3259 (3.5%) had type 1 diabetes. Lower-extremity amputation was performed in 1.7% and 0.8% of the patients with type 1 and type 2 diabetes, respectively. The prevalence of amputation did not differ significantly between men and women with type 1 diabetes but was significantly higher among men than among women with type 2 diabetes (0.9% v. 0.7%). Height (every 10-cm increment) was significantly associated with lower-extremity amputation (adjusted odds ratio [OR] 1.16, 95% confidence interval [CI] 1.03-1.32). In a subgroup of 9295 patients for whom data on fasting plasma glucose levels and dyslipidemia were available, and after additional adjustment for these 2 variables, body height remained an independent predictor of lower-extremity amputation (adjusted OR for every 10 cm of height 1.79, 95% CI 1.14-2.82).
Height is an independent predictor of lower-extremity amputation among patients with type 1 and type 2 diabetes mellitus.
与身材较矮的糖尿病患者相比，身材较高的糖尿病患者发生周围感觉丧失的风险更高，因此下肢溃疡和截肢的风险可能增加。在一项大型电话调查中，确定了糖尿病患者下肢截肢的患病率，并评估了身高与下肢截肢之间的关联。
从医院和诊所数据库中识别出在1995年至1998年间被诊断为糖尿病且在这些机构就诊的256,036例患者，随机选择128,572例在1995年至2002年间通过电话进行访谈。在同意接受访谈的93,484例患者中，排除了386例（年龄<18岁）；这使得93,116例糖尿病患者（42,970例男性和50,146例女性）被纳入研究。
在接受访谈的93,116例患者中，3259例（3.5%）患有1型糖尿病。1型和2型糖尿病患者的下肢截肢率分别为1.7%和0.8%。1型糖尿病患者中，截肢患病率在男性和女性之间无显著差异，但在2型糖尿病患者中，男性的截肢患病率显著高于女性（0.9%对0.7%）。身高（每增加10厘米）与下肢截肢显著相关（调整后的优势比[OR]为1.16，95%置信区间[CI]为1.03 - 1.32）。在9295例可获得空腹血糖水平和血脂异常数据的患者亚组中，在对这两个变量进行额外调整后，身高仍然是下肢截肢的独立预测因素（每10厘米身高的调整后OR为1.79，95% CI为1.14 - 2.82）。
身高是1型和2型糖尿病患者下肢截肢的独立预测因素。
