Tomita Masuomi, Kabeya Yusuke, Okisugi Mari, Katsuki Takeshi, Oikawa Yoichi, Atsumi Yoshihito, Matsuoka Kempei, Shimada Akira
Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Tokyo 108-0073, Japan.
Division of General Internal Medicine, Department of Internal Medicine, Tokai University Hachioji Hospital, Tokyo, Japan.
J Diabetes Res. 2016;2016:5938540. doi: 10.1155/2016/5938540. Epub 2016 Feb 29.
To determine the diabetic foot ulcer incidence and examine its association with microangiopathy complications, including diabetic retinopathy (DR) and albuminuria (Alb), in type 2 diabetes patients.
This was a retrospective cohort study of 1,305 patients with type 2 diabetes who were assigned to the following groups: Category 1, normoalbuminuria without DR (n = 712); Category 2, Alb without DR (n = 195); Category 3, normoalbuminuria with DR (n = 185); and Category 4, Alb with DR (n = 213). Cox proportional hazard models were used to compare the risks of developing diabetic foot ulcers across the categories.
During 14,249 person-years of follow-up, 50 subjects developed diabetic foot ulcers, with incidence rates of 1.6/1,000, 1.5/1,000, 3.4/1,000, and 12.5/1,000 person-years in Categories 1, 2, 3, and 4, respectively. After adjusting for the presence of diabetic neuropathy and macroangiopathy, the hazard ratios and 95% confidence intervals (CIs) for the risk of diabetic foot ulcer development were 0.66 (95% CI, 0.18-2.36), 1.72 (95% CI, 0.67-4.42), and 3.17 (95% CI, 1.52-6.61) in Categories 2, 3, and 4, respectively, compared with Category 1.
The presence of DR and Alb significantly increases the risk of diabetic foot ulcer development.
确定2型糖尿病患者糖尿病足溃疡的发生率，并研究其与微血管病变并发症（包括糖尿病视网膜病变（DR）和蛋白尿（Alb））之间的关联。
这是一项对1305例2型糖尿病患者的回顾性队列研究，这些患者被分为以下几组：第1组，无DR的正常白蛋白尿（n = 712）；第2组，有Alb但无DR（n = 195）；第3组，有DR的正常白蛋白尿（n = 185）；第4组，有Alb且有DR（n = 213）。采用Cox比例风险模型比较各组发生糖尿病足溃疡的风险。
在14249人年的随访期间，50名受试者发生了糖尿病足溃疡，第1、2、3和4组的发病率分别为每1000人年1.6例、1.5例、3.4例和12.5例。在调整了糖尿病神经病变和大血管病变的存在后，与第1组相比，第2、3和4组发生糖尿病足溃疡风险的风险比及95%置信区间（CI）分别为0.66（95%CI，0.18 - 2.36）、1.72（95%CI，0.67 - 4.42）和3.17（95%CI，1.52 - 6.61）。
DR和Alb的存在显著增加了糖尿病足溃疡发生的风险。
