{"title":"Association between anemia and the risk of diabetic foot ulcer: A meta-analysis.","authors":"Shi-Shuai Lin, Cun-Ren Chen, Wei-Cheng Xu, Jia Fu, Jia-Qin Xu, Zun-Hong Liang","doi":"10.4239/wjd.v16.i6.105155","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Aim: </strong>To investigate the relationship between anemia and the risk of DFUs in diabetic patients through a meta-analysis.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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, <i>n</i> = 166173, OR: 2.72, 95%CI: 1.73-4.25, <i>P</i> < 0.001; <i>I</i> <sup>2</sup> = 93%). Subgroup analyses supported consistent findings across various patient characteristics, analytic models, and study quality scores (<i>P</i> for subgroup differences, all > 0.05). Additionally, each 1-g/dL decrease in hemoglobin was associated with an excess risk of DFUs (four studies, <i>n</i> = 2543, OR: 1.65, 95%CI: 1.21-2.27, <i>P</i> = 0.002; <i>I</i> <sup>2</sup> = 68%). Furthermore, diabetic patients with DFUs exhibited significantly lower hemoglobin levels compared to those without DFUs (nine studies, <i>n</i> = 3986, mean difference: -2.13 g/dL, 95%CI: -2.58 to -1.68, <i>P</i> < 0.001; <i>I<sup>2</sup></i> = 90%).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 6","pages":"105155"},"PeriodicalIF":4.2000,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179917/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Diabetes","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4239/wjd.v16.i6.105155","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Background: 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.
Aim: To investigate the relationship between anemia and the risk of DFUs in diabetic patients through a meta-analysis.
Methods: 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.
Results: 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, n = 166173, OR: 2.72, 95%CI: 1.73-4.25, P < 0.001; I2 = 93%). Subgroup analyses supported consistent findings across various patient characteristics, analytic models, and study quality scores (P for subgroup differences, all > 0.05). Additionally, each 1-g/dL decrease in hemoglobin was associated with an excess risk of DFUs (four studies, n = 2543, OR: 1.65, 95%CI: 1.21-2.27, P = 0.002; I2 = 68%). Furthermore, diabetic patients with DFUs exhibited significantly lower hemoglobin levels compared to those without DFUs (nine studies, n = 3986, mean difference: -2.13 g/dL, 95%CI: -2.58 to -1.68, P < 0.001; I2 = 90%).
Conclusion: 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.
期刊介绍:
The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.