Lin Shi-Shuai, Chen Cun-Ren, Xu Wei-Cheng, Fu Jia, Xu Jia-Qin, Liang Zun-Hong
Department of Burn and Skin Repair Surgery, Affiliated Hainan Hospital of Hainan Medical University, Hainan General Hospital, Haikou 570311, Hainan Province, China.
Department of Endocrinology, Affiliated Hainan Hospital of Hainan Medical University, Hainan General Hospital, Haikou 570311, Hainan Province, China.
World J Diabetes. 2025 Jun 15;16(6):105155. doi: 10.4239/wjd.v16.i6.105155.
Diabetic foot ulcers (DFUs) are a major complication of diabetes mellitus, and anemia is commonly observed in diabetic patients. However, the relationship between anemia and the risk of developing DFUs remains unclear.
To investigate the relationship between anemia and the risk of DFUs in diabetic patients through a meta-analysis.
A systematic search was conducted across PubMed, Embase, and Web of Science databases to identify studies that reported the co-occurrence of anemia and DFUs in diabetic patients. The primary outcome was an association between anemia and DFU risk, expressed as odds ratios (ORs). Secondary outcomes included the risk of DFU per 1-g/dL decrease in hemoglobin and the difference in hemoglobin levels between patients with and without DFU. Statistical analyses were performed using random-effects models to account for heterogeneity.
Sixteen studies involving 170,949 diabetic patients were included in the analysis. The results indicated a significant association between anemia and an increased risk of DFUs (eight studies, = 166173, OR: 2.72, 95%CI: 1.73-4.25, < 0.001; = 93%). Subgroup analyses supported consistent findings across various patient characteristics, analytic models, and study quality scores ( for subgroup differences, all > 0.05). Additionally, each 1-g/dL decrease in hemoglobin was associated with an excess risk of DFUs (four studies, = 2543, OR: 1.65, 95%CI: 1.21-2.27, = 0.002; = 68%). Furthermore, diabetic patients with DFUs exhibited significantly lower hemoglobin levels compared to those without DFUs (nine studies, = 3986, mean difference: -2.13 g/dL, 95%CI: -2.58 to -1.68, < 0.001; = 90%).
Anemia can be associated with an increased risk of DFUs in diabetic patients. Monitoring and managing anemia in diabetic population may help mitigate the risk of DFUs, emphasizing the need for early interventions. Further research is required to investigate the underlying mechanisms and potential therapeutic strategies.
糖尿病足溃疡（DFUs）是糖尿病的主要并发症，贫血在糖尿病患者中很常见。然而，贫血与发生DFUs风险之间的关系仍不清楚。
通过荟萃分析研究糖尿病患者中贫血与DFUs风险之间的关系。
在PubMed、Embase和科学网数据库中进行系统检索，以识别报告糖尿病患者中贫血和DFUs同时出现的研究。主要结局是贫血与DFU风险之间的关联，以比值比（ORs）表示。次要结局包括血红蛋白每降低1 g/dL时DFU的风险，以及有和没有DFU的患者之间血红蛋白水平的差异。使用随机效应模型进行统计分析以考虑异质性。
分析纳入了16项涉及170,949名糖尿病患者的研究。结果表明贫血与DFUs风险增加之间存在显著关联（八项研究，n = 166173，OR：2.72，95%CI：1.73 - 4.25，P < 0.001；I² = 93%）。亚组分析支持在各种患者特征、分析模型和研究质量评分中结果一致（亚组差异的P值，均> 0.05）。此外，血红蛋白每降低1 g/dL与DFUs风险增加相关（四项研究，n = 2543，OR：1.65，95%CI：1.21 - 2.27，P = 0.002；I² = 68%）。此外，与没有DFUs的糖尿病患者相比，患有DFUs的糖尿病患者血红蛋白水平显著更低（九项研究，n = 3986，平均差异：-2.13 g/dL，95%CI：-2.58至-1.68，P < 0.001；I² = 90%）。
贫血可能与糖尿病患者发生DFUs的风险增加相关。监测和管理糖尿病人群中的贫血可能有助于降低DFUs风险，强调了早期干预的必要性。需要进一步研究以调查潜在机制和潜在治疗策略。
