Department of Endocrinology, Peking University First Hospital, Beijing, China.
Plastic and Burn Surgery Department, Peking University First Hospital, Beijing, China.
Front Endocrinol (Lausanne). 2022 Jun 6;13:824215. doi: 10.3389/fendo.2022.824215. eCollection 2022.
Diabetic peripheral neuropathy (DPN), peripheral artery disease (PAD), and foot deformity are the most common causes of diabetic foot, which can considerably worsen the patient's quality of life. In this study, we aimed to investigate the prevalence and risk factors associated with DPN, PAD, and foot deformity among patients with diabetes living in Beijing, China. In total, 3,898 diabetes patients from 11 hospitals in Beijing were evaluated using questionnaires and physical examinations, and 3,758 patients were included in the analysis. We compared the demographic, clinical, biological characteristics, and comorbidities of patients with and without DPN, PAD, or foot deformity, and used binary logistic regression analysis to identify potential factors associated with these outcomes. Overall, 882 patients (23.5%) had DPN, 437 patients (11.6%) had PAD, and 1,117 patients (29.7%) had foot deformities, including callus. The risk factors for DPN included: age ≥40 years, a ≥10+year duration of diabetes, a body mass index of <18.5 kg/m or ≥24 kg/m, a systolic blood pressure (SBP) of ≥140 mm Hg, a hemoglobin A (HbA) level of ≥7%, chronic kidney disease, and cerebrovascular disease. The risk factors for PAD included: a 15+ year diabetes duration, a body mass index of <18.5 kg/m, a SBP of ≥140 mm Hg, a HbA level of ≥7%, chronic kidney disease, coronary heart disease, and cerebrovascular disease. The risk factors for skeletal foot deformities included: women, age ≥40 years, a SBP ≥140 mm Hg, and hyperlipidemia. The risk factors for callus formation included: women, a SBP ≥140 mm Hg, and hyperlipidemia. In conclusion, the prevalence of foot deformities was higher than DPN and PAD in patients with diabetes. Managing the risk factors for DPN, PAD, and foot deformity is important for reducing the risk of diabetic foot.
糖尿病周围神经病变（DPN）、外周动脉疾病（PAD）和足部畸形是糖尿病足最常见的病因，可显著降低患者的生活质量。本研究旨在探讨中国北京地区糖尿病患者 DPN、PAD 和足部畸形的患病率及其相关危险因素。共对北京 11 家医院的 3898 例糖尿病患者进行问卷调查和体格检查，其中 3758 例患者纳入分析。我们比较了伴有和不伴有 DPN、PAD 或足部畸形的患者的人口统计学、临床、生物学特征和合并症，采用二项逻辑回归分析识别这些结局的潜在相关因素。结果显示，总体有 882 例（23.5%）患者患有 DPN，437 例（11.6%）患者患有 PAD，1117 例（29.7%）患者患有足部畸形，包括胼胝。DPN 的危险因素包括：年龄≥40 岁、糖尿病病程≥10 年、体重指数（BMI）＜18.5 kg/m²或≥24 kg/m²、收缩压（SBP）≥140 mm Hg、糖化血红蛋白（HbA）水平≥7%、慢性肾脏病和脑血管病。PAD 的危险因素包括：糖尿病病程≥15 年、BMI＜18.5 kg/m²、SBP≥140 mm Hg、HbA 水平≥7%、慢性肾脏病、冠心病和脑血管病。骨骼性足部畸形的危险因素包括：女性、年龄≥40 岁、SBP≥140 mm Hg 和高脂血症。胼胝形成的危险因素包括：女性、SBP≥140 mm Hg 和高脂血症。总之，糖尿病患者足部畸形的患病率高于 DPN 和 PAD。管理 DPN、PAD 和足部畸形的危险因素对于降低糖尿病足的风险非常重要。
