Salini Dharmadas, Harish Kumar, Minnie Pillay, Sundaram Karimassery R, Arun Bal, Sandya Chirukandath J, Mangalanandan Thacho S, Vivek Lakshmanan, Praveen Valiyaparambil P
Department of Anatomy, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India.
Department of Endocrinology, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India.
Indian J Endocrinol Metab. 2018 Jan-Feb;22(1):107-111. doi: 10.4103/ijem.IJEM_257_17.
Available literature on the prevalence of Charcot arthropathy (CA) represents mainly Western population. No study has been reported from India so far. Hence we attempted to study the prevalence of CA in patients with type 2 diabetes mellitus and severe peripheral neuropathy (T2DMPN), belonging to Indian population amongst whom type 2 diabetes is on the rise in alarming proportions.
Medical records of 3387 patients who performed an objective vibration perception threshold test during the year 2015 were screened for T2DMPN. Out of these, 1475 T2DMPN patients above 50 years were selected and analyzed in detail for CA. CA was diagnosed based on clinical features and/or radiological investigations. The anatomical localization of the disease distribution of the affected foot was done according to Brodsky's classification.
The prevalence of CA in T2DMPN patients was found to be 9.8%. The mean age of patients diagnosed with CA was 63 ± 8.36 years, and mean duration of DM for CA to develop was 18.01 ± 8.23 years. About 62.5% of the patients were male and 37.5% female. Bilateral presentation of CA was observed in 20.8% of patients. Multiple sites of the foot were affected in 48.6% of patients and belonged to type 4 classification of Brodsky.
A high prevalence of CA (9.8%) was observed in the present study conducted on T2DMPN patients who presented to the endocrinology department of a tertiary care South Indian hospital. In the majority of patients, the area of foot affected belonged to type 4 classification of Brodsky.
关于夏科氏关节病（CA）患病率的现有文献主要来自西方人群。迄今为止，印度尚无相关研究报道。因此，我们试图研究2型糖尿病合并严重周围神经病变（T2DMPN）患者中CA的患病率，这些患者属于印度人群，其中2型糖尿病正以惊人的比例上升。
对2015年进行客观振动觉阈值测试的3387例患者的病历进行筛查，以确定T2DMPN患者。其中，选取1475例50岁以上的T2DMPN患者，对CA进行详细分析。CA根据临床特征和/或影像学检查进行诊断。根据布罗德斯基分类法对患足疾病分布的解剖定位进行分类。
T2DMPN患者中CA的患病率为9.8%。诊断为CA的患者平均年龄为63±8.36岁，CA发生的糖尿病平均病程为18.01±8.23年。约62.5%的患者为男性，37.5%为女性。20.8%的患者观察到CA双侧发病。48.6%的患者足部多个部位受累，属于布罗德斯基分类的4型。
在对一家南印度三级护理医院内分泌科就诊的T2DMPN患者进行的本研究中，观察到CA的高患病率（9.8%）。在大多数患者中，患足区域属于布罗德斯基分类的4型。
