Department of Endocrinology, Peking University First Hospital, Beijing, China.
Department of Endocrinology, The Second Hospital of Shijiazhuang, Shijiazhuang, China.
Front Endocrinol (Lausanne). 2024 Aug 7;15:1441997. doi: 10.3389/fendo.2024.1441997. eCollection 2024.
Large-scale prospective cohort studies on diabetic foot ulcers risk factor screening in China are limited. Therefore, this prospective cohort study aimed to explore the predictive risk factors for diabetic foot ulcers to provide clinicians with concise and effective clinical indicators for identifying a high-risk diabetic foot and guiding the prevention of diabetic foot ulcers.
Patients with diabetes who visited the Department of Endocrinology of Peking University First Hospital from October 2017 to December 2018 were selected as research participants by convenience sampling. A total of 968 patients were included. After enrollment, a dedicated person collected and recorded all baseline data. A dedicated telephone follow-up was conducted every 12-24 months to evaluate whether the endpoint event had occurred. All patients were followed up for an average of 61 (57-71) months, with 95% of them followed up for more than 60 months. According to the occurrence of endpoint events, they were divided into the DFU and non-DFU groups. The data between the two groups were analyzed using independent-sample t-test, Wilcoxon rank sum test, and chi square test. We used univariate and multivariate logistic regression analysis to analyze the factors that affected the occurrence of diabetic foot ulcers.
After the 5-year follow-up, the incidence of diabetic foot was 25.83%. Multivariate logistic regression analysis revealed that body mass index (odds ratio: 1.046; 95% confidence interval: 1.001-1.093), abnormal pinprick sensation (odds ratio: 4.138; 95% confidence interval: 1.292-13.255), history of fungal foot infection (odds ratio: 2.287; 95% confidence interval: 1.517-3.448), abnormal 128-Hz tuning fork test (odds ratio: 2.628; 95% confidence interval: 1.098-6.294), and HbA1c≥ 8% (odds ratio: 1.522; 95% confidence interval: 1.014-2.284) were independent predictors of diabetic foot. Our study highlights clinically relevant indicators that may help to prevent the occurrence of diabetic foot and guide timely interventions.
在中国，关于糖尿病足溃疡风险因素筛查的大规模前瞻性队列研究有限。因此，本前瞻性队列研究旨在探讨糖尿病足溃疡的预测性风险因素，为临床医生提供简洁有效的临床指标，以识别高风险的糖尿病足，并指导糖尿病足溃疡的预防。
采用便利抽样法，选取 2017 年 10 月至 2018 年 12 月期间在北京大学第一医院内分泌科就诊的糖尿病患者作为研究对象。共纳入 968 例患者。入组后，专人采集并记录所有基线资料。每 12-24 个月进行一次专门的电话随访，评估终点事件是否发生。所有患者平均随访 61（57-71）个月，95%的患者随访时间超过 60 个月。根据终点事件的发生情况，将患者分为糖尿病足溃疡组和非糖尿病足溃疡组。采用独立样本 t 检验、Wilcoxon 秩和检验和卡方检验对两组间数据进行分析。采用单因素和多因素 logistic 回归分析影响糖尿病足溃疡发生的因素。
经过 5 年随访，糖尿病足的发生率为 25.83%。多因素 logistic 回归分析显示，体质指数（比值比：1.046；95%置信区间：1.001-1.093）、异常针刺觉（比值比：4.138；95%置信区间：1.292-13.255）、真菌性足感染史（比值比：2.287；95%置信区间：1.517-3.448）、128-Hz 音叉试验异常（比值比：2.628；95%置信区间：1.098-6.294）和糖化血红蛋白≥8%（比值比：1.522；95%置信区间：1.014-2.284）是糖尿病足的独立预测因素。本研究突出了具有临床相关性的指标，可能有助于预防糖尿病足的发生，并指导及时干预。
