School of Life Sciences and Education, Staffordshire University, Science Centre, Leek Road, Stoke on Trent ST4 2DF, United Kingdom.
School of Life Sciences and Education, Staffordshire University, Science Centre, Leek Road, Stoke on Trent ST4 2DF, United Kingdom.
J Diabetes Complications. 2019 Jun;33(6):437-444. doi: 10.1016/j.jdiacomp.2019.02.006. Epub 2019 Mar 1.
The aim of this study was to identify the biomechanical, neurological and clinical parameters along with other demographics and lifestyle risk factors that could explain the presence of foot ulcer in patients with diabetes in Africa.
A total of 1270 (M/F:696/574) patients; 77(M/F:53/24) with ulcerated vs 1193 (M/F: 643/550) with non-ulcerated feet; participated in this study. A set of 28 parameters were collected and compared between the participants with and without active foot ulcers. Multivariate logistic regression was utilised to develop an explanatory model for foot ulceration.
Foot swelling (χ2(1,n = 1270) = 265.9,P = 0.000,Phi = 0.464) and impaired sensation to monofilament (χ2(2,n = 1270) = 114.2,P = 0.000,Cramer'sV = 0.300) showed strong association with presence of ulceration. A lower Temperature sensitivity to cold stimuli and limited ankle joint mobility were observed to be significant (P < 0.05) contributors to ulceration. The logistic regression model can justify the presence of foot ulceration with 95.3% diagnostic accuracy, 99.1% specificity and 37.3% sensitivity.
Participants with ulcerated foot show distinct characteristics in few foot related parameters. Swollen foot, limited ankle mobility, and peripheral sensory neuropathy were significant characteristics of patients with diabetic foot ulcer. One out of three patients with ulcerated foot showed common characteristics that could be justified by the model.
本研究旨在确定生物力学、神经学和临床参数以及其他人口统计学和生活方式风险因素，以解释非洲糖尿病患者足部溃疡的发生。
共有 1270 名患者（男/女：696/574）参与了这项研究，其中 77 名（男/女：53/24）患有溃疡，1193 名（男/女：643/550）患有非溃疡足。收集了一组 28 个参数，并在有和没有活动性足部溃疡的参与者之间进行了比较。利用多元逻辑回归建立了一个解释足部溃疡的模型。
足部肿胀（χ2(1,n=1270)=265.9，P=0.000，Phi=0.464）和单丝感觉受损（χ2(2,n=1270)=114.2，P=0.000，Cramer's V=0.300）与溃疡的存在有很强的关联。较低的冷刺激温度敏感性和踝关节活动度受限被认为是溃疡的重要（P<0.05）因素。逻辑回归模型可以用 95.3%的诊断准确性、99.1%的特异性和 37.3%的敏感性来解释足部溃疡的存在。
患有溃疡足的参与者在少数足部相关参数中表现出明显的特征。肿胀的足部、有限的踝关节活动度和周围感觉神经病变是糖尿病足溃疡患者的显著特征。三分之一的溃疡足患者表现出的共同特征可以用该模型来解释。
