Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of High Education, Manipal, Karnataka, India.
Manipal Centre for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Front Endocrinol (Lausanne). 2023 Mar 29;14:1152854. doi: 10.3389/fendo.2023.1152854. eCollection 2023.
Diabetic foot ulcers (DFU) are a major complication of diabetes mellitus (DM). Nutrient deficiencies are among the major risk factors in DFU development and healing. In this context, we aimed to investigate the possible association between micronutrient status and risk of DFU.
A systematic review (Prospero registration: CRD42021259817) of articles, published in PubMed, Web of Science, Scopus, CINAHL Complete, and Embase, that measured the status of micronutrients in DFU patients was performed.
Thirty-seven studies were considered, of which thirty were included for meta-analysis. These studies reported levels of 11 micronutrients: vitamins B9, B12, C, D, E, calcium, magnesium, iron, selenium, copper, and zinc. DFU, compared to healthy controls (HC) had significantly lower vitamin D (MD: -10.82 14 ng/ml, 95% CI: -20.47, -1.16), magnesium (MD: -0.45 mg/dL, 95% CI: -0.78, -0.12) and selenium (MD: -0.33 µmol/L, 95% CI: -0.34, -0.32) levels. DFU, compared to DM patients without DFU, had significantly lower vitamin D (MD: -5.41 ng/ml, 95% CI: -8.06, -2.76), and magnesium (MD: -0.20 mg/dL, 95% CI: -0.25, -0.15) levels. The overall analysis showed lower levels of vitamin D [15.55ng/ml (95% CI:13.44, 17.65)], vitamin C [4.99µmol/L (95% CI:3.16, 6.83)], magnesium [1.53mg/dL (95% CI:1.28, 1.78)] and selenium [0.54µmol/L (95% CI:0.45, 0.64)].
This review provides evidence that micronutrient levels significantly differ in DFU patients, suggesting an association between micronutrient status and risk of DFU. Therefore, routine monitoring and supplementations are warranted in DFU patients. We suggest that personalized nutrition therapy may be considered in the DFU management guidelines.
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=259817, identifier CRD42021259817.
糖尿病足溃疡（DFU）是糖尿病（DM）的主要并发症。营养缺乏是 DFU 发生和愈合的主要危险因素之一。在这种情况下，我们旨在研究微量营养素状况与 DFU 风险之间的可能关联。
对发表在 PubMed、Web of Science、Scopus、CINAHL Complete 和 Embase 上的文章进行了系统评价（Prospero 注册：CRD42021259817），这些文章测量了 DFU 患者的微量营养素状况。
考虑了 37 项研究，其中 30 项纳入了荟萃分析。这些研究报告了 11 种微量营养素的水平：维生素 B9、B12、C、D、E、钙、镁、铁、硒、铜和锌。与健康对照组（HC）相比，DFU 患者的维生素 D（MD：-10.82 14ng/ml，95%CI：-20.47，-1.16）、镁（MD：-0.45mg/dL，95%CI：-0.78，-0.12）和硒（MD：-0.33μmol/L，95%CI：-0.34，-0.32）水平显著降低。与无 DFU 的 DM 患者相比，DFU 患者的维生素 D（MD：-5.41ng/ml，95%CI：-8.06，-2.76）和镁（MD：-0.20mg/dL，95%CI：-0.25，-0.15）水平显著降低。总体分析显示，维生素 D [15.55ng/ml（95%CI：13.44，17.65）]、维生素 C [4.99μmol/L（95%CI：3.16，6.83）]、镁 [1.53mg/dL（95%CI：1.28，1.78）]和硒 [0.54μmol/L（95%CI：0.45，0.64）]水平较低。
本综述提供的证据表明，DFU 患者的微量营养素水平显著不同，提示微量营养素状态与 DFU 风险之间存在关联。因此，DFU 患者需要常规监测和补充。我们建议在 DFU 管理指南中考虑个性化营养治疗。
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=259817，标识符 CRD42021259817。
