Pinto A, Tuttolomondo A, Di Raimondo D, La Placa S, Di Sciacca R, Fernandez P, Di Gati M, Raffa A, Licata G
Biomedical Department of Internal and Specialistic Medicine P Giaccone Polyclinic, University of Palermo, Palermo, Italy.
Int Angiol. 2007 Sep;26(3):266-9.
The diabetic foot syndrome is the most frequent cause of hospitalization of diabetic patients and one of the economically most demanding complications of diabetes. People with diabetes have been shown to have higher mortality than people without diabetes, but the cerebrovascular risk profile of these patients is not fully evaluated. The aim of our study was to evaluate the possible role of diabetic foot as a cerebrovascular risk marker in type 2 diabetic patients.
We enrolled 102 type 2 diabetes patients with diabetic foot and 123 diabetic patients without diabetic foot.
Statistically significant differences were found in the distribution of the main cardiovascular risk factors with exception of hypertension. We observed a higher prevalence of previous cerebrovascular events (transient ischemic attack, ischemic stroke) and of incidence of new onset cerebrovascular events at a 5-year follow-up. Regarding clinical subtype of ischemic stroke classified according to Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification on a retrospective and prospective basis, we observed a higher prevalence of both the lacunar and large artery atherosclerosis subtype with a slight higher prevalence of lacunar subtype in patients with diabetic foot.
Our results show a worse cerebrovascular risk profile in diabetic patients with diabetic foot than in diabetic subjects without foot ulceration with a higher prevalence of cardiovascular risk factors and of anamnestic cerebrovascular events and incidence of new cerebrovascular events at a 5-year follow-up.
糖尿病足综合征是糖尿病患者住院最常见的原因，也是糖尿病经济负担最重的并发症之一。已证明糖尿病患者的死亡率高于非糖尿病患者，但这些患者的脑血管风险状况尚未得到充分评估。我们研究的目的是评估糖尿病足作为2型糖尿病患者脑血管风险标志物的可能作用。
我们纳入了102例患有糖尿病足的2型糖尿病患者和123例无糖尿病足的糖尿病患者。
除高血压外，主要心血管危险因素的分布存在统计学显著差异。我们观察到既往脑血管事件（短暂性脑缺血发作、缺血性卒中）的患病率较高，以及在5年随访中新发脑血管事件的发生率较高。关于根据急性卒中治疗中ORG 10172试验（TOAST）分类回顾性和前瞻性分类的缺血性卒中临床亚型，我们观察到腔隙性和大动脉粥样硬化亚型的患病率均较高，糖尿病足患者的腔隙性亚型患病率略高。
我们的结果显示，患有糖尿病足的糖尿病患者的脑血管风险状况比无足部溃疡的糖尿病患者更差，心血管危险因素、既往脑血管事件的患病率以及5年随访中新发脑血管事件的发生率更高。
