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血尿素氮浓度与糖尿病足溃疡之间的关联:一项基于美国国家健康与营养检查调查(NHANES)的回顾性横断面研究。

Association between blood urea nitrogen concentration and diabetic foot ulcer: A retrospective cross-sectional study based on NHANES.

作者信息

Li Ruijing, Li Changfan

机构信息

Guangzhou University of Chinese Medicine, Guangzhou, China.

The First Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China.

出版信息

Medicine (Baltimore). 2025 Aug 29;104(35):e44038. doi: 10.1097/MD.0000000000044038.

Abstract

This study explores the relationship between blood urea nitrogen (BUN) levels and diabetic foot ulcer (DFU) in patients over the age of 40 in the United States. A total of 1673 participants who took part in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004 were included in this study. Four logistic regression models were developed to assess the relationship between BUN levels and DFU. Smoothed curve-fitting analysis and threshold effect analysis were used to further specify the type of association. Subsequently, subgroup analyses were performed using stratified multiple regression analysis with age, sex, body mass index (BMI), and HbA1C. The study included 1622 adults with a mean age of 64.60 ± 11.82 years, of which 53.08% were male. Of the participants, 131 (8.07%) had DFU. In a multivariate logistic regression model, the highest BUN level was strongly associated with an increased risk of DFU (OR = 3.56, 95% CI: 1.47-8.62; P = .007). Smooth curve-fitting analysis showed a linear correlation between BUN and DFU (P for nonlinear = .056), with a threshold point of BUN = 5.4 mmol/L. These results suggest a possible linear positive correlation between BUN levels and DFU. Regular monitoring of BUN levels in diabetic patients can be helpful for early diagnosis and intervention of DFU.

摘要

本研究探讨了美国40岁以上患者血尿素氮(BUN)水平与糖尿病足溃疡(DFU)之间的关系。共有1673名参与1999年至2004年美国国家健康和营养检查调查(NHANES)的参与者纳入本研究。建立了四个逻辑回归模型来评估BUN水平与DFU之间的关系。采用平滑曲线拟合分析和阈值效应分析进一步明确关联类型。随后,使用年龄、性别、体重指数(BMI)和糖化血红蛋白(HbA1C)的分层多元回归分析进行亚组分析。该研究纳入了1622名成年人,平均年龄为64.60±11.82岁,其中53.08%为男性。参与者中,131人(8.07%)患有DFU。在多变量逻辑回归模型中,最高BUN水平与DFU风险增加密切相关(OR = 3.56,95% CI:1.47 - 8.62;P = 0.007)。平滑曲线拟合分析显示BUN与DFU之间存在线性相关性(非线性P = 0.056),BUN阈值点为5.4 mmol/L。这些结果表明BUN水平与DFU之间可能存在线性正相关。定期监测糖尿病患者的BUN水平有助于DFU的早期诊断和干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65c0/12401242/32ab7fd4f949/medi-104-e44038-g001.jpg

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