García-Álvarez Yolanda, Lázaro-Martínez José Luis, García-Morales Esther, Cecilia-Matilla Almudena, Aragón-Sánchez Javier, Carabantes-Alarcón David
Unidad de Pie Diabético, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain.
Diabetes Metab Syndr. 2013 Apr-Jun;7(2):78-82. doi: 10.1016/j.dsx.2013.02.029. Epub 2013 Mar 15.
To determine the structural and biomechanical characteristics associated with the conditions diabetes mellitus and diabetic neuropathy.
Observational study of 788 patients conducted between February 2007 and February 2009, which included subjects with and without diabetes mellitus who had no active ulcer at enrollment. Demographic variables and the general and specific history of diabetes mellitus were recorded. The patient's foot type according to the Foot Posture Index, joint mobility and deformity were recorded.
No associations were found between the different foot types (neutral, pronated and supinated) and the structural and demographic variables at a general level, except for the pronated foot that was associated with a higher body mass index, longer suffering from diabetes and the presence of neuropathy [p<0.001, OR (95% CI): 6.017 (4.198-8.624); p<0.001, OR (95% CI): 1.710 (1.266-2.309); p=0.010, OR (95% CI): 0.759 (0.615-0.937), respectively].
The confluence of risk factors such as neuropathy, body mass index, duration of diabetes and limited joint mobility in patients with diabetes mellitus and pronated foot may be a high-risk anthropometric pattern for developing associated complications such as Charcot foot. A prospective analysis of these patients is required to define the risk for developing Charcot neuroarthropathy.
确定与糖尿病及糖尿病神经病变相关的结构和生物力学特征。
对2007年2月至2009年2月期间的788例患者进行观察性研究，其中包括入组时无活动性溃疡的糖尿病患者和非糖尿病患者。记录人口统计学变量以及糖尿病的一般和特殊病史。根据足姿势指数记录患者的足型、关节活动度和畸形情况。
总体而言，除了旋前足与较高的体重指数、较长的糖尿病病程和神经病变的存在相关外[p<0.001，比值比（95%可信区间）：6.017（4.198 - 8.624）；p<0.001，比值比（95%可信区间）：1.710（1.266 - 2.309）；p = 0.010，比值比（95%可信区间）：0.759（0.615 - 0.937）]，不同足型（中立型、旋前型和旋后型）与结构和人口统计学变量之间未发现关联。
糖尿病合并旋前足患者中，神经病变、体重指数、糖尿病病程和关节活动受限等危险因素的共同作用可能是发生夏科氏足等相关并发症的高危人体测量模式。需要对这些患者进行前瞻性分析以确定发生夏科氏神经关节病的风险。
