糖尿病足肌少症患者SINBAD系统评分与伤口pH值的相关性研究

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability Pub Date : 2025-04-12 DOI:10.1016/j.jtv.2025.100915

Wang Hui , Yang Yaping , Gong Liqing , Mao Zhigang , Peng yinbo , Wang Jing

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引用次数: 0

摘要

目的探讨SINBAD系统评分结合创面pH值对糖尿病足肌少症的诊断价值。方法采用横断面观察性临床研究。从2023年6月至2024年6月，连续入组上海杨浦医院门诊的糖尿病足患者。收集的数据包括骨骼肌指数、握力、6米步行速度、SINBAD系统分类、伤口pH值。根据欧洲肌少症工作组的诊断标准，将患者分为三组：非肌少症组、肌少症前期组和肌少症组。组间比较采用单因素方差分析、Kruskal-Wallis H检验或卡方检验。采用Spearman相关分析评估SINBAD系统评分与肌少症相关指标的相关性。采用Pearson相关分析评价创面pH值与肌少症相关指标的相关性。采用二元logistic回归分析糖尿病足患者肌肉减少症的影响因素。采用受试者工作特征（ROC）曲线评价SINBAD系统评分结合创面pH值对糖尿病足肌少症的诊断价值。结果共纳入71例糖尿病足患者。其中，29人属于非肌少症组，13人属于肌少症前期组，29人属于肌少症组。与非肌少症组和肌少症前期组相比，肌少症组的糖尿病病程和糖尿病足病病程均明显延长(P <；0.05)。与非肌肉减少症组和肌肉减少症前期组相比，肌肉减少症组的握力较低(P <；0.05)。肌少症组骨骼肌指数（SMI）显著低于非肌少症组和肌少症前期组(P <；0.05)。Pearson相关分析显示，创面pH值与SMI呈负相关(r = - 0.476, P <；0.001)和握力(r = - 0.478, P <；0.05)。Spearman相关分析显示，SINBAD系统评分与SMI呈负相关(r = - 0.716, P <；0.05)和握力(r = - 0.666, P <；0.05)。二元logistic回归分析显示，创面pH值升高（OR = 29.126, 95% CI 1.234 ~ 687.583）和SINBAD系统评分升高（OR = 5.271, 95% CI 2.144 ~ 12.961）是影响糖尿病足患者肌少症发生的重要因素。ROC曲线分析显示，创面pH值与SINBAD系统评分联合对糖尿病足患者肌肉减少症具有较高的诊断价值，曲线下面积（AUC）为0.933。结论创面pH值和SINBAD系统评分与糖尿病足患者肌少症的发生有关，对该人群的肌少症有诊断价值。

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Study on the correlation between SINBAD system score and wound pH value in diabetic foot sarcopenia

Objective

To investigate the diagnostic value of the SINBAD system score combined with wound pH value in diabetic foot sarcopenia.

Methods

This is a cross-sectional observational clinical study. From June 2023 to June 2024, diabetic foot patients attending the outpatient clinic of Shanghai Yangpu hospital were consecutively enrolled. Data collected included skeletal muscle index, grip strength, 6-m walking speed, SINBAD system classification, and wound pH value. Based on the diagnostic criteria of the European Working Group on Sarcopenia, patients were classified into three groups: Non-sarcopenia group, pre-sarcopenia group, and sarcopenia group. Between-group comparisons were made using one-way ANOVA, Kruskal-Wallis H test, or Chi-square test. Spearman's correlation analysis was used to assess the correlation between the SINBAD system score and sarcopenia-related indicators. Pearson's correlation analysis was employed to evaluate the correlation between wound pH and sarcopenia-related indicators. Binary logistic regression was performed to analyze the factors influencing sarcopenia in diabetic foot patients. The diagnostic value of the SINBAD system score combined with wound pH value in diabetic foot sarcopenia was assessed using receiver operating characteristic (ROC) curves.

Results

A total of 71 diabetic foot patients were enrolled. Of these, 29 were in the Non-sarcopenia group, 13 in the pre-sarcopenia group, and 29 in the sarcopenia group. Compared with the Non-sarcopenia group and pre-sarcopenia group, the sarcopenia group had significantly longer diabetes duration and diabetic foot disease duration (P < 0.05). The sarcopenia group had lower grip strength compared to both the Non-sarcopenia group and pre-sarcopenia group (P < 0.05). The skeletal muscle index (SMI) of the sarcopenia group was significantly lower than that of the Non-sarcopenia group and pre-sarcopenia group (P < 0.05). Pearson correlation analysis showed that wound pH value was negatively correlated with SMI (r = −0.476, P < 0.001) and grip strength (r = −0.478, P < 0.05). Spearman correlation analysis revealed that the SINBAD system score was negatively correlated with SMI (r = −0.716, P < 0.05) and grip strength (r = −0.666, P < 0.05). Binary logistic regression analysis indicated that an increased wound pH value (OR = 29.126, 95 % CI 1.234–687.583) and higher SINBAD system score (OR = 5.271, 95 % CI 2.144–12.961) were significant factors influencing the presence of sarcopenia in diabetic foot patients. ROC curve analysis showed that the combination of wound pH value and SINBAD system score had a high diagnostic value for sarcopenia in diabetic foot patients, with an area under the curve (AUC) of 0.933.

Conclusion

The wound pH value and SINBAD system score are associated with the occurrence of sarcopenia in diabetic foot patients and have diagnostic value for sarcopenia in this population.

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来源期刊

Journal of tissue viability DERMATOLOGY-NURSING

CiteScore

3.80

自引率

16.00%

发文量

110

审稿时长

>12 weeks

期刊介绍： The Journal of Tissue Viability is the official publication of the Tissue Viability Society and is a quarterly journal concerned with all aspects of the occurrence and treatment of wounds, ulcers and pressure sores including patient care, pain, nutrition, wound healing, research, prevention, mobility, social problems and management. The Journal particularly encourages papers covering skin and skin wounds but will consider articles that discuss injury in any tissue. Articles that stress the multi-professional nature of tissue viability are especially welcome. We seek to encourage new authors as well as well-established contributors to the field - one aim of the journal is to enable all participants in tissue viability to share information with colleagues.