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一项评估糖尿病患者周围神经病变临床特征的真实世界多中心横断面观察性研究。

A real-world multicenter cross-sectional observational study to assess the clinical profile of peripheral neuropathy in patients with diabetes.

作者信息

Rastogi Ashu, Ravindranath Venkatesan, Dubey Anupama, Gude Dilip, Agarwal Manish, Prajapati Hiren, Verberk Willem Jan

机构信息

Department of Endocrinology and Metabolism Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Prabhu Diabetes Speciality Centre, Trichy, Tamil Nadu, India.

出版信息

PLoS One. 2025 Apr 15;20(4):e0312085. doi: 10.1371/journal.pone.0312085. eCollection 2025.

Abstract

BACKGROUND

There are limited studies on the prevalence of diabetic peripheral neuropathy (DPN) and related foot deformities in patients with T2DM from India.

AIM

To investigate the prevalence, characteristics, and risk factors for foot deformities in Asian-Indian individuals with T2DM and DPN.

METHODS

We analyzed 4290 patients (32.3% female, 67.7% male, mean age 51.1 ± 9.3 years) using a cross-sectional, retrospective observational method, focusing on signs and symptoms of foot complications and neuropathy.

RESULTS

Dry Skin (44%), infection (19.7%), and ingrown toenails (16.6%) were the foremost prevalent foot health conditions. The most common neuropathic symptoms were burning (35.4%), muscle cramps (31.5%), and loss of sensation (26.6%). Multivariable logistic regression analysis identified nephropathy (OR 3.96 [95% CI: 3.02-5.20]), retinopathy (OR 3.85 [95% CI: 2.72-5.48]), coronary disease (OR 3.48 [95% CI: 2.42-5.04]), COVID-19 history (OR 2.37 [95% CI: 1.73-3.26]), smoking (OR 2.13 [95% CI: 1.56-2.91]), hypertension (OR 2.10 [95% CI: 1.63-2.73]), dyslipidemia (OR 2.09 [95% CI: 1.62-2.69]), alcohol use (OR 1.57 [95% CI: 1.14-2.15]), and high HbA1c (OR 1.29 [95% CI: 1.16-1.42]) as significant predictors (p < 0.001) of increased risk for multiple foot health complications. Diabetes duration showed no significant correlation with increased risk for multiple foot complications.

CONCLUSION

This study revealed a significant incidence of foot deformities and neuropathic symptoms in Indian T2DM patients, influenced by various lifestyle and medical factors. The lack of correlation between diabetes duration and foot complications in the present study highlights the need for enhanced diabetes management and early detection strategies in India.

摘要

背景

关于印度2型糖尿病(T2DM)患者中糖尿病周围神经病变(DPN)及相关足部畸形患病率的研究有限。

目的

调查亚洲印度裔T2DM和DPN患者足部畸形的患病率、特征及危险因素。

方法

我们采用横断面回顾性观察方法分析了4290例患者(女性占32.3%,男性占67.7%,平均年龄51.1±9.3岁),重点关注足部并发症和神经病变的体征和症状。

结果

皮肤干燥(44%)、感染(19.7%)和嵌甲(16.6%)是最常见的足部健康问题。最常见的神经病变症状是灼痛(35.4%)、肌肉痉挛(31.5%)和感觉丧失(26.6%)。多变量逻辑回归分析确定肾病(比值比[OR]3.96[95%置信区间:3.02 - 5.20])、视网膜病变(OR 3.85[95%置信区间:2.72 - 5.48])、冠心病(OR 3.48[95%置信区间:2.42 - 5.04])、新冠病毒疾病史(OR 2.37[95%置信区间:1.73 - 3.26])、吸烟(OR 2.13[95%置信区间:1.56 - 2.91])、高血压(OR 2.10[95%置信区间:1.63 - 2.73])、血脂异常(OR 2.09[95%置信区间:1.62 - 2.69])、饮酒(OR 1.57[95%置信区间:1.14 - 2.15])和高糖化血红蛋白(OR 1.29[95%置信区间:1.16 - 1.42])是多种足部健康并发症风险增加的显著预测因素(p < 0.001)。糖尿病病程与多种足部并发症风险增加无显著相关性。

结论

本研究揭示了印度T2DM患者中足部畸形和神经病变症状的高发生率,受多种生活方式和医学因素影响。本研究中糖尿病病程与足部并发症缺乏相关性,凸显了印度加强糖尿病管理和早期检测策略的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f01/11999154/29f562c1737c/pone.0312085.g001.jpg

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