振动感知阈值和体重指数与 2 型糖尿病门诊患者的足底压力异常有关。
Vibrating perception threshold and body mass index are associated with abnormal foot plantar pressure in type 2 diabetes outpatients.
机构信息
Department of Endocrinology & Metabolism, Shanghai Jiaotong University-Affiliated Sixth People's Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Institute for Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai, China.
出版信息
Diabetes Technol Ther. 2012 Nov;14(11):1053-9. doi: 10.1089/dia.2012.0146. Epub 2012 Aug 30.
AIMS
This study investigated the influencing factors of foot plantar pressure and attempted to find practical indicators to predict abnormal foot pressure in patients with type 2 diabetes mellitus (T2DM).
SUBJECTS AND METHODS
Vibration perception threshold (VPT) and foot plantar pressure in 1,126 T2DM outpatients were examined. Patients were assigned to Group A (n=599), Group B (n=312), and Group C (n=215) according to VPT values and to Group I (n=555), Group II (n=436), and Group III (n=135) based on body mass index (BMI). The clinical characteristics and pressure-time integral (PTI) were compared among the three groups, and the associated factors of the total PTI in the entire foot (T-PTI) were analyzed.
RESULTS
PTI of Group C in heel medial and heel lateral was significantly higher than that of Group A (all P<0.01). PTI of Group B in the right fifth metatarsal and heel medial was significantly higher than that of Group A (all P<0.05). T-PTI of Group C was significantly higher than those of Groups A and B, and that of Group B was higher than that of Group A (all P<0.01). PTI of Groups II and III in the second, third, and fourth metatarsal, midfoot, heel medial, and heel lateral was significantly higher than that of Group I (all P<0.05). T-PTI of Groups II and III was significantly higher than that of Group I (all P<0.01). Pearson correlation analysis showed that T-PTI was positively associated with age, VPT, waist circumference, waist-to-hip ratio, and BMI (P<0.05). In multiple stepwise regression analysis, VPT (P=0.004) and BMI (P=0.000) were independent risk factors of T-PTI, and each 1 unit increase in BMI increased the T-PTI by 5.962 kPa•s. Receiver operator characteristic curve analysis further revealed that the optimal cutpoint of VPT and BMI to predict the abnormal PTI was 21 V (odds ratio=2.33, 95% confidence interval 1.67-3.25) and 24.9 kg/m(2) (odds ratio=2.12, 95% confidence interval 1.55-2.90), respectively.
CONCLUSIONS
Having a VPT higher than 21 V and a BMI above 24.9 kg/m(2) increases the risk of excessive foot plantar pressure in Chinese T2DM.
目的
本研究旨在探讨足底压力的影响因素，并试图寻找实用指标来预测 2 型糖尿病（T2DM）患者的异常足底压力。
受试者和方法
对 1126 例 T2DM 门诊患者进行了振动感觉阈值（VPT）和足底压力检查。根据 VPT 值将患者分为 A 组（n=599）、B 组（n=312）和 C 组（n=215），并根据体重指数（BMI）分为 I 组（n=555）、II 组（n=436）和 III 组（n=135）。比较三组间的临床特征和压力时间积分（PTI），分析整个足部总 PTI（T-PTI）的相关因素。
结果
C 组患者足跟内侧和足跟外侧的 PTI 明显高于 A 组（均 P<0.01）。B 组患者右侧第五跖骨和足跟内侧的 PTI 明显高于 A 组（均 P<0.05）。C 组的 T-PTI 明显高于 A 组和 B 组，B 组的 T-PTI 也高于 A 组（均 P<0.01）。II 组和 III 组患者第二、三、四跖骨、中足、足跟内侧和足跟外侧的 PTI 明显高于 I 组（均 P<0.05）。II 组和 III 组的 T-PTI 明显高于 I 组（均 P<0.01）。Pearson 相关分析显示，T-PTI 与年龄、VPT、腰围、腰臀比和 BMI 呈正相关（P<0.05）。多元逐步回归分析显示，VPT（P=0.004）和 BMI（P=0.000）是 T-PTI 的独立危险因素，BMI 每增加 1kg/m2，T-PTI 增加 5.962kPa•s。受试者工作特征曲线分析进一步显示，VPT 和 BMI 预测异常 PTI 的最佳截断值分别为 21V（优势比=2.33，95%置信区间 1.67-3.25）和 24.9kg/m2（优势比=2.12，95%置信区间 1.55-2.90）。
结论
VPT 高于 21V 和 BMI 高于 24.9kg/m2 会增加中国 2 型糖尿病患者足底压力过大的风险。
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