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糖尿病患者周围神经病变的预测因素:一项多中心横断面研究。

Predictors of Peripheral Neuropathy Among Persons with Diabetes Mellitus: A Multicenter Cross-Sectional Study.

作者信息

Lawal Yakubu, Mshelia-Reng Rifkatu, Omonua Special Odiase, Odumodu Kenechukwu, Shuaibu Ramatu, Itanyi Ukamaka Dorothy, Abubakar Amina Ibrahim, Kolade-Yunusa Hadijat Oluseyi, David Zumnan Songden, Ogunlana Babajide, Clarke Andrew, Adediran Olufemi, Ehusani Caleb O, Abbas Zulfiqarali, Anumah Felicia Ehusani

机构信息

*College of Health Sciences, University of Abuja, Abuja, Nigeria.

†Memorial Hermann Southwest Hospital, Houston, TX.

出版信息

J Am Podiatr Med Assoc. 2025 Jan-Feb;115(1). doi: 10.7547/l22-053.

Abstract

BACKGROUND

Diabetic peripheral neuropathy (DPN) is a microvascular complication of diabetes mellitus (DM) that causes substantial morbidities, including pain, foot ulcers, lower-limb amputations, and depression. It is said to affect approximately 50% of adults with DM. Understanding the predictors of DPN will help refocus on early preventive strategies to reduce its numerous morbidities.

METHODS

A total of 1,040 persons with DM were consecutively enrolled. Relevant medical history, clinical examinations, and laboratory investigations were performed. Multiple logistic regression was used to determine predictors of DPN. Significance was set at P ≤ .05.

RESULTS

Significant predictors of DPN included age (odds ratio [OR], 1.99; P = .003); female sex (OR, 1.94; P = .023); DM duration (OR, 2.01; P = .032); history of systemic hypertension (OR, 1.68; P = .037); height (OR, 2.02; P = .001); generalized obesity (OR, 2.02; P = .002); central obesity (OR, 1.12; P = .047); poor control of systolic blood pressure (OR, 1.78; P = .001), diastolic blood pressure (OR, 1.45; P = .006), fasting plasma glucose (OR, 2.43; P = .004), 2-hour postprandial glucose (2HrPP) (OR, 2.83; P = .001), and glycated hemoglobin (OR, 2.31; P = .004); and peripheral artery disease (OR, 1.89; P = .002). The negative predictors of DPN include antidiabetics (OR, 2.39; P = .008), antihypertensives (OR, 2.45; P = .009), statins (OR, 2.21; P = .004), and antiplatelets (OR, 2.46; P = .030).

CONCLUSIONS

Significant predictors of DPN include age, DM duration, female sex, height, history of systemic hypertension, and obesity. Others include poor control of systolic and diastolic blood pressure, fasting plasma glucose, 2HrPP, and glycated hemoglobin levels. Negative predictors include antidiabetics, antihypertensives, statins, and antiplatelets.

摘要

背景

糖尿病周围神经病变(DPN)是糖尿病(DM)的一种微血管并发症,可导致严重的发病情况,包括疼痛、足部溃疡、下肢截肢和抑郁。据说它影响了约50%的成年糖尿病患者。了解DPN的预测因素将有助于重新聚焦于早期预防策略,以减少其众多的发病情况。

方法

连续纳入了1040名糖尿病患者。进行了相关的病史采集、临床检查和实验室检查。采用多因素逻辑回归来确定DPN的预测因素。显著性设定为P≤0.05。

结果

DPN的显著预测因素包括年龄(比值比[OR],1.99;P = 0.003);女性(OR,1.94;P = 0.023);糖尿病病程(OR,2.01;P = 0.032);系统性高血压病史(OR,1.68;P = 0.037);身高(OR,2.02;P = 0.001);全身性肥胖(OR,2.02;P = 0.002);中心性肥胖(OR,1.12;P = 0.047);收缩压控制不佳(OR,1.78;P = 0.001)、舒张压控制不佳(OR,1.45;P = 0.006)、空腹血糖(OR,2.43;P = 0.004)、餐后2小时血糖(2HrPP)(OR,2.83;P = 0.001)和糖化血红蛋白(OR,2.31;P = 0.004);以及外周动脉疾病(OR,1.89;P = 0.002)。DPN的负性预测因素包括抗糖尿病药物(OR,2.39;P = 0.008)、抗高血压药物(OR,2.45;P = 0.009)、他汀类药物(OR,2.21;P = 0.004)和抗血小板药物(OR,2.46;P = 0.030)。

结论

DPN的显著预测因素包括年龄、糖尿病病程、女性、身高、系统性高血压病史和肥胖。其他因素包括收缩压和舒张压控制不佳、空腹血糖、餐后2小时血糖以及糖化血红蛋白水平。负性预测因素包括抗糖尿病药物、抗高血压药物、他汀类药物和抗血小板药物。

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