Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Diabetes Care. 2011 Mar;34(3):649-51. doi: 10.2337/dc10-1712. Epub 2011 Jan 27.
To examine the 25-year cumulative incidence of lower-extremity amputation (LEA) in people with type 1 diabetes.
Cumulative incidence of LEA was ascertained in Wisconsin Epidemiologic Study of Diabetic Retinopathy participants (n = 943) using the Kaplan-Meier approach accounting for competing risk of death. Relationships of baseline characteristics with incidence of LEA were explored using a proportional hazards approach with discrete linear regression modeling.
The overall 25-year incidence of LEA was 10.1%. In multivariate analyses (results reported as odds ratio; 95% CI), being male (3.90; 2.29-6.65), heavy smoking (2.07; 1.11-3.85), having hypertension (3.36; 1.91-5.93), diabetic retinopathy (2.62; 1.13-6.09), neuropathy (1.68; 1.02-2.76), and higher HbA(1c) (per 1% 1.40; 1.24-1.58) were independently associated with the incidence of LEA.
Our results show a high 25-year incidence of LEA and suggest that glycemic control and blood pressure control and preventing heavy smoking may result in reduction in its incidence.
研究 1 型糖尿病患者下肢截肢（LEA）的 25 年累积发生率。
采用 Kaplan-Meier 方法（考虑死亡的竞争风险），通过威斯康星州糖尿病视网膜病变流行病学研究参与者（n=943）确定 LEA 的累积发生率。使用比例风险方法和离散线性回归模型探索基线特征与 LEA 发生率的关系。
总体 25 年 LEA 的发生率为 10.1%。在多变量分析中（结果报告为比值比；95%置信区间），男性（3.90；2.29-6.65）、大量吸烟（2.07；1.11-3.85）、高血压（3.36；1.91-5.93）、糖尿病视网膜病变（2.62；1.13-6.09）、神经病变（1.68；1.02-2.76）和更高的 HbA1c（每增加 1%，1.40；1.24-1.58）与 LEA 的发生率独立相关。
我们的结果显示 LEA 的 25 年发生率较高，表明血糖控制和血压控制以及预防大量吸烟可能会降低其发生率。
