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与感染或肢体截肢无关的夏科氏关节病相关的较高全身炎症状态和心血管风险。

Higher systemic inflammatory status and cardiovascular risk associated with Charcot arthropathy unrelated to infection or extremity amputation.

作者信息

de Vasconcelos Jessica Castro, Atala Yeelen Ballesteros, Zantut-Wittmann Denise Engelbrecht, Parisi Maria Cândida Ribeiro

机构信息

Endocrinology Division, Department of Internal Medicine (Endocrinology), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo Brazil.

出版信息

J Diabetes Metab Disord. 2022 Jun 20;21(2):1407-1413. doi: 10.1007/s40200-022-01073-5. eCollection 2022 Dec.

Abstract

PURPOSE

People with diabetes and Charcot arthropathy have higher mortality than people with diabetes without this complication. Are the causes of this higher mortality exclusively infectious or of a cardiovascular origin? We aimed to study aspects related to cardiovascular risk and inflammation in a population of people with type 2 diabetes with and without Charcot arthropathy.

METHODS

A cross-sectional study was performed in people with diabetes and Charcot Eickenholtz III arthropathy, matched for sex and age, with two groups of people with diabetes without Charcot arthropathy with and without peripheral sensory-motor neuropathy, in the absence of active infection. All participants underwent clinical and laboratory evaluation at the time of the interview, and their cardiovascular risk was calculated according to the United Kingdom Prospective Diabetes Study (UKPDS) calculator.

RESULTS

We evaluated 69 people with type 2 diabetes (21 with Charcot arthropathy, 24 with diabetic peripheral neuropathy and 24 without this neuropathy), with a mean age between 57 and 61 years and with a diabetes duration of more than 10 years. Patients with Charcot arthropathy had a longer duration of diabetes; more frequency of dyslipidemia; and higher levels of uric acid, microalbuminuria and C-reactive protein than the other two groups. A total of 73.9% of the people evaluated had high or very high cardiovascular risk according to the UKPDS score.

CONCLUSION

The people with type 2 diabetes presenting Charcot arthropathy had greater values of systemic inflammatory parameters, even in the chronic phase of the complication, with a higher risk of mortality unrelated to infections.

摘要

目的

患有糖尿病和夏科氏关节病的患者比没有这种并发症的糖尿病患者死亡率更高。这种较高死亡率的原因完全是感染性的还是心血管源性的?我们旨在研究2型糖尿病合并和不合并夏科氏关节病患者群体中与心血管风险和炎症相关的方面。

方法

对患有糖尿病和夏科氏艾肯霍尔茨III型关节病的患者进行横断面研究,这些患者按性别和年龄匹配,分为两组,一组是患有糖尿病但没有夏科氏关节病且伴有外周感觉运动神经病变的患者,另一组是患有糖尿病但没有夏科氏关节病且不伴有外周感觉运动神经病变的患者,且均无活动性感染。所有参与者在访谈时均接受了临床和实验室评估,并根据英国前瞻性糖尿病研究(UKPDS)计算器计算其心血管风险。

结果

我们评估了69名2型糖尿病患者(21名患有夏科氏关节病,24名患有糖尿病外周神经病变,24名没有这种神经病变),平均年龄在57至61岁之间,糖尿病病程超过10年。与其他两组相比,患有夏科氏关节病的患者糖尿病病程更长;血脂异常频率更高;尿酸、微量白蛋白尿和C反应蛋白水平更高。根据UKPDS评分,共有73.9%的评估患者具有高或非常高的心血管风险。

结论

患有夏科氏关节病的2型糖尿病患者即使在并发症的慢性期,全身炎症参数值也更高,且与感染无关的死亡风险更高。

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