血液重金属与美国成人糖尿病足溃疡的关系：来自1999-2004年NHANES数据的见解

IF 3.8 3区医学 Q2 Medicine

Diabetes Therapy Pub Date : 2025-03-28 DOI:10.1007/s13300-025-01730-x

Jia-Hao Xing, Yang Yu, Lin Teng, Xue-Ying Hui, Wei-Guang Guo

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引用次数: 0

摘要

糖尿病足溃疡（DFU）是糖尿病的严重并发症。这些溃疡显著增加了截肢的风险。许多研究调查了血液中的重金属如何影响糖尿病患者的胰岛素分泌。然而，将血液重金属暴露与DFU联系起来的研究是有限的。本研究旨在探讨糖尿病患者血液重金属暴露与DFU之间的关系。方法：本横断面研究使用1999-2004年国家健康和营养检查调查（NHANES）周期的数据。研究人员使用电感耦合等离子体质谱（ICP-MS）测量了血液中的铅（Pb）和镉（Cd）水平。四个逻辑回归模型评估了血液重金属与DFU患病率之间的关系。这些模型对潜在的混杂因素进行了调整。并采用平滑曲线拟合和分段回归分析进一步探讨相关性。亚组分析和相互作用测试有助于评估一般人群的一致性。结果：共有1664名年龄在40岁或以上的糖尿病患者被纳入最终分析。平均年龄64.66±11.79岁，男性占52.52%，女性占47.48%。其中135例（8.11%）被诊断为DFU。统计模型显示血镉（Cd）水平与DFU患病率之间存在显著正相关。其中，经充分调整的模型4显示，血Cd水平每增加一个单位，DFU患病率相应增加64% [OR = 1.64；95% CI (1.42-1.89), p = 0.004]。通过光滑曲线拟合的进一步分析表明，血Cd水平与DFU患病率之间存在显著的线性关系。结论：本研究发现血镉（Cd）水平与DFU患病率呈正相关。这些结果表明，在随访期间监测糖尿病患者的血Cd水平可能对预防DFU的发展很重要。然而，需要进一步的前瞻性研究来提供额外的证据。

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Association of Blood Heavy Metals with Diabetic Foot Ulcers in U.S. Adults with Diabetes: Insights from the 1999-2004 NHANES Data.

Introduction: Diabetic foot ulcers (DFU) are serious complications of diabetes. These ulcers significantly increase the risk of amputations. Many studies have examined how blood heavy metals affect insulin secretion in diabetes. However, research linking blood heavy metal exposure to DFU is limited. This study aims to explore the connection between blood heavy metal exposure and DFU in people with diabetes.

Methods: This cross-sectional study used data from the 1999-2004 cycle of the National Health and Nutrition Examination Survey (NHANES). Researchers measured blood levels of lead (Pb) and cadmium (Cd) using inductively coupled plasma mass spectrometry (ICP-MS). Four logistic regression models assessed the relationship between blood heavy metals and the prevalence of DFU. The models adjusted for potential confounding factors. Additionally, smooth curve fitting and piecewise regression analyses were conducted to investigate the correlation further. Subgroup analyses and interaction tests helped evaluate consistency across the general population.

Results: A total of 1664 participants aged 40 years or older with diabetes were included in the final analysis. The average age is 64.66 ± 11.79 years, with 52.52% being male and 47.48% being female. Among these individuals, 135 (8.11%) were diagnosed with DFU. Statistical modeling revealed a significant positive correlation between blood cadmium (Cd) levels and the prevalence of DFU. Specifically, model 4, which was the fully adjusted model, indicated that for each unit increase in blood Cd level, there was a corresponding 64% increase in DFU prevalence [OR = 1.64; 95% CI (1.42-1.89), p = 0.004]. Further analysis through smooth curve fitting demonstrated a significant linear relationship between blood Cd levels and DFU prevalence.

Conclusions: This study identified a positive correlation between blood cadmium (Cd) levels and the prevalence of DFU. These results suggest that monitoring blood Cd levels in patients with diabetes during follow-up may be important for preventing the development of DFU. However, further prospective studies are necessary to provide additional evidence.

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来源期刊

Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.90

自引率

7.90%

发文量

130

审稿时长

6 weeks

期刊介绍： Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.