Nehring Piotr, Mrozikiewicz-Rakowska Beata, Krzyżewska Monika, Sobczyk-Kopcioł Agnieszka, Płoski Rafał, Broda Grażyna, Karnafel Waldemar
Gastroenterology and Metabolic Diseases Department, Medical University of Warsaw, ul. Banacha 1a, Warsaw 02-097, Poland.
Department of General Biology and Parazytology, Medical University of Warsaw, Warsaw, Poland.
J Diabetes Metab Disord. 2014 Aug 4;13:79. doi: 10.1186/2251-6581-13-79. eCollection 2014.
Diabetic foot is a serious condition in patients with a long lasting diabetes mellitus. Diabetic foot treated improperly may lead not only to delayed ulceration healing, generalized inflammation, unnecessary surgical intervention, but also to the lower limb amputation. The aim of this study was to compare diabetic foot risk factors in population with type 2 diabetes and risk factors for diabetes in healthy subjects.
The study included 900 subjects: 145 with diabetic foot, 293 with type 2 diabetes without diabetic foot and 462 healthy controls matched in terms of mean age, gender structure and cardiovascular diseases absence. Study was conducted in Gastroenterology and Metabolic Diseases Department, Medical University of Warsaw, Poland. In statistical analysis a logistic regression model, U Mann-Whitney's and t-Student test were used.
The binomial logit models analysis showed that the risk of diabetic foot in patients with type 2 diabetes was decreased by patient's age (odds ratio [OR] = 0.94; 95% confidence interval [CI]: 0.92-0.96; p = 0.00001) and hyperlipidaemia (OR = 0.54; 95% CI: 0.36-0.81; p = 0.01). In contrast, male gender (OR = 2.83; 95% CI: 1.86-4.28; p = 0.00001) diabetes duration (OR = 1.04; 95% CI: 1.03-1.06; p = 0.0003), weight (OR = 1.04; 95% CI: 1.03-1.06; p = 0.00001), height (OR = 1.08; 95% CI: 1.05-1.11; p = 0.00001) and waist circumference (OR = 1.028; 95% CI: 1.007-1.050; p = 0.006) increase the risk of diabetic foot. The onset of type 2 diabetes in healthy subjects was increased by weight (OR = 1.035; 95% CI: 1.024-1.046; p = 0.00001), WC (OR = 1.075; 95% CI: 1.055-1.096; p = 00001), hip circumference (OR = 1.03; 95% CI: 1.01-1.05; p = 0.005), overweight defined with body mass index (BMI) above 24,9 kg/m(2) (OR = 2.49; 95% CI: 1.77-3.51; p = 0.00001) and hyperlipidaemia (OR = 3.53; 95% CI: 2.57-4.84; p = 0.00001).
Risk factors for Type 2 diabetes and diabetic foot are only partially common. Study proved that patients who are prone to developing diabetic foot experience different risk factors than patients who are at risk of diabetes. Identification of relationship between diabetic foot and diabetes risk factors in appropriate groups may help clinicians to focus on certain factors in diabetic foot prevention.
糖尿病足是长期糖尿病患者的一种严重病症。糖尿病足若治疗不当，不仅可能导致溃疡愈合延迟、全身性炎症、不必要的手术干预，还可能导致下肢截肢。本研究的目的是比较2型糖尿病患者群体中的糖尿病足危险因素与健康受试者中的糖尿病危险因素。
该研究纳入了900名受试者：145名患有糖尿病足，293名患有2型糖尿病但无糖尿病足，以及462名在平均年龄、性别结构和无心血管疾病方面相匹配的健康对照者。研究在波兰华沙医科大学胃肠病学和代谢疾病科进行。在统计分析中，使用了逻辑回归模型、U曼-惠特尼检验和t检验。
二项逻辑模型分析表明，2型糖尿病患者患糖尿病足的风险因患者年龄（比值比[OR]=0.94；95%置信区间[CI]：0.92 - 0.96；p = 0.00001）和高脂血症（OR = 0.54；95% CI：0.36 - 0.81；p = 0.01）而降低。相比之下，男性性别（OR = 2.83；95% CI：1.86 - 4.28；p = 0.00001）、糖尿病病程（OR = 1.04；95% CI：1.03 - 1.06；p = 0.0003）、体重（OR = 1.04；95% CI：1.03 - 1.06；p = 0.00001）、身高（OR = 1.08；95% CI：1.05 - 1.11；p = 0.00001）和腰围（OR = 1.028；95% CI：1.007 - 1.050；p = 0.006）会增加糖尿病足的风险。健康受试者中2型糖尿病的发病因体重（OR = 1.035；95% CI：1.024 - 1.046；p = 0.00001）、腰围（OR = 1.075；95% CI：1.055 - 1.096；p = 00001）、臀围（OR = 1.03；95% CI：1.01 - 1.05；p = 0.005）、体重指数（BMI）高于24.9 kg/m²定义的超重（OR = 2.49；95% CI：1.77 - 3.51；p = 0.00001）和高脂血症（OR = 3.53；95% CI：2.57 - 4.84；p = 0.00001）而增加。
2型糖尿病和糖尿病足的危险因素仅部分相同。研究证明，易患糖尿病足的患者与有糖尿病风险的患者经历的危险因素不同。识别适当群体中糖尿病足与糖尿病危险因素之间的关系可能有助于临床医生在糖尿病足预防中关注某些因素。
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