First School of Clinical Medicine, Shandong University of Traditional Chinese Medicine, China.
Department of Peripheral Vascular Disease, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, China.
Vascular. 2024 Jun;32(3):661-669. doi: 10.1177/17085381231154805. Epub 2023 Feb 5.
To systematically evaluate the risk factors for developing diabetic foot ulcers (DFU).
The Cochrane Library, PubMed, Web of Science, SinoMed, CNKI, VIP, and Wanfang Data were searched for relevant studies on DFU risk factors, and the search time frame was from database creation to March 2022. Meta-analysis was performed using RevMan 5.3.
A total of 26 publications were included, including 3 cohort studies, 22 case-control studies, and one cross-sectional study. Meta-analysis showed that advanced age [MD = 6.04, 95% CI (3.92, 8.16)], male [OR = 1.84, 95% CI (1.48, 2.29)], elevated body mass index [MD = 1.58, 95% CI (0.47, 2.69)], prolonged duration of diabetes [MD = 2.72, 95% CI (2.33, 3.11)], comorbid nephropathy [OR = 3.15, 95% CI (2.68, 4.60)], comorbid neuropathy [OR = 4.80, 95% CI (2.79, 8.27)], comorbid retinopathy [OR = 3.37, 95% CI (2.26, 5.02)], elevated systolic blood pressure [OR = 8.19, 95% CI (6.33, 10.05)], elevated fasting glucose [MD = 1.60, 95% CI (0.21, 3.00)], elevated glycated hemoglobin [MD = 1.24, 95% CI (0.94, 1.54)], elevated triglycerides [MD = 0.44 (95% CI (0.15, 0.73)], elevated fibrinogen [MD = 1.35, 95% CI (0.62, 2.08)], elevated white blood cell count [MD = 2.56, 95% CI (2.24, 2.88)], elevated C-reactive protein [MD = 15.08, 95% CI (8.03, 22.13)], decreased ankle-brachial ratio [MD = -0.26, 95% CI (-0.36, -0.16)], and decreased total protein levels [MD = -4.58, 95% CI (-6.91, -2.25)] were risk factors for developing DFU ( < 0.05), and increased HDL cholesterol levels [MD = -0.22, 95% CI (-0.36, -0.08)] were protective factor for developing DFU ( < 0.05).
There are many risk factors for developing of ulcers in the diabetic feet, and early prevention and intervention should be performed as early as possible to assess the risk of developing diabetic foot patients.
系统评价糖尿病足溃疡（DFU）的危险因素。
检索 Cochrane 图书馆、PubMed、Web of Science、SinoMed、CNKI、VIP 和万方数据库中关于 DFU 危险因素的相关研究，检索时间从数据库创建到 2022 年 3 月。使用 RevMan 5.3 进行荟萃分析。
共纳入 26 篇文献，包括 3 项队列研究、22 项病例对照研究和 1 项横断面研究。Meta 分析结果显示，高龄 [MD = 6.04，95%CI（3.92，8.16）]、男性 [OR = 1.84，95%CI（1.48，2.29）]、超重 [BMI 升高] [MD = 1.58，95%CI（0.47，2.69）]、糖尿病病程延长 [MD = 2.72，95%CI（2.33，3.11）]、合并肾病 [OR = 3.15，95%CI（2.68，4.60）]、合并神经病变 [OR = 4.80，95%CI（2.79，8.27）]、合并视网膜病变 [OR = 3.37，95%CI（2.26，5.02）]、收缩压升高 [OR = 8.19，95%CI（6.33，10.05）]、空腹血糖升高 [MD = 1.60，95%CI（0.21，3.00）]、糖化血红蛋白升高 [MD = 1.24，95%CI（0.94，1.54）]、甘油三酯升高 [MD = 0.44（95%CI（0.15，0.73）]、纤维蛋白原升高 [MD = 1.35，95%CI（0.62，2.08）]、白细胞计数升高 [MD = 2.56，95%CI（2.24，2.88）]、C 反应蛋白升高 [MD = 15.08，95%CI（8.03，22.13）]、踝肱指数降低 [MD = -0.26，95%CI（-0.36，-0.16）]和总蛋白水平降低 [MD = -4.58，95%CI（-6.91，-2.25）]是发生 DFU 的危险因素（ < 0.05），而高密度脂蛋白胆固醇水平升高 [MD = -0.22，95%CI（-0.36，-0.08）]是发生 DFU 的保护因素（ < 0.05）。
糖尿病足溃疡的发生有多种危险因素，应尽早进行早期预防和干预，评估糖尿病足患者发生溃疡的风险。
