Monami Matteo, Vivarelli Maria, Desideri Carla Maria, Colombi Claudia, Marchionni Niccolò, Mannucci Edoardo
Department of Cardiovascular Medicine, University of Florence and Azienda Ospedaliera Careggi, Florence, Italy.
Diabetes Care. 2009 May;32(5):897-9. doi: 10.2337/dc08-1679. Epub 2009 Feb 5.
To assess the relevance of pulse pressure as a predictor of foot ulcers in type 2 diabetic subjects.
A cohort study was performed on a consecutive series of 1,945 type 2 diabetic outpatients without a foot ulcer at baseline. Incident foot ulcers were identified through the regional hospital discharge system, which contains ICD codes of current diagnoses.
During a follow-up of mean +/- SD 4.2 +/- 2.2 years, 86 ulcers were observed. After adjusting for confounders, the highest quartiles of pulse pressure had a 2.39-fold (95% CI 1.14-5.02) risk of foot ulcers. When ischemic ulcers were considered separately, the highest pulse pressure quartile was associated with an increased age- and sex-adjusted risk (2.08 [95% CI 1.02-4.24]), whereas no increase of risk was observed for neuropathic ulcers.
Elevated pulse pressure represents an independent predictor of foot ulcers in diabetic patients; this parameter should be considered for the stratification of risk of ischemic or neuroischemic ulcers.
评估脉压作为2型糖尿病患者足部溃疡预测指标的相关性。
对1945例基线时无足部溃疡的2型糖尿病门诊患者进行了一项队列研究。通过包含当前诊断ICD编码的地区医院出院系统识别新发足部溃疡。
在平均±标准差为4.2±2.2年的随访期间，观察到86例溃疡。在对混杂因素进行校正后，脉压最高四分位数发生足部溃疡的风险为2.39倍（95%可信区间1.14 - 5.02）。当单独考虑缺血性溃疡时，脉压最高四分位数与年龄和性别校正后的风险增加相关（2.08 [95%可信区间1.02 - 4.24]），而对于神经性溃疡未观察到风险增加。
脉压升高是糖尿病患者足部溃疡的独立预测指标；在对缺血性或神经缺血性溃疡风险进行分层时应考虑该参数。
