糖尿病的严重程度和糖尿病足截肢的风险:一项国家队列研究。

IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Jin Yu, Ji-Hyun Kim, Bongseong Kim, Kyungdo Han, Seung Hwan Lee, Mee Kyoung Kim
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引用次数: 0

摘要

背景:本研究旨在评估糖尿病严重程度指标是否可以作为2型糖尿病患者截肢风险的预测因素。方法:我们分析了具有全国代表性的韩国国民健康保险系统数据库的数据,追踪了2009年至2012年期间参加常规健康检查的2,544,077例2型糖尿病患者,随访时间一直持续到2018年底。用于定义糖尿病严重程度评分的参数包括糖尿病持续时间、胰岛素使用、口服降糖药物的数量、慢性肾脏疾病、糖尿病视网膜病变和心血管疾病的存在。每个因素被赋予1分,产生从0到6的累积严重性评分。结果:糖尿病足截肢的风险主要由胰岛素治疗、糖尿病视网膜病变和糖尿病持续时间延长预测。脚截肢的风险比率增加而严重程度评分如下:2.31(95%可信区间(CI), 2.15 - 2.47) 1分,4.73(95%可信区间,4.42至5.07)2分,8.86(95%可信区间,8.24至9.53)3分16.95 (95% CI, 15.60 - 18.4)的4分,23.98(95%可信区间,21.25至27.05),5分和37.87(95%可信区间,28.93至49.57)得分为6。结论:晚期糖尿病的特异性标志物可有效识别糖尿病足截肢风险升高的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Severity of Diabetes and the Risk of Diabetic Foot Amputation: A National Cohort Study.

Background: This study aimed to assess whether markers of diabetes severity could serve as predictors for foot amputation risk among patients with type 2 diabetes mellitus.

Methods: We analyzed data from the nationally representative Korean National Health Insurance System database, tracking 2,544,077 patients with type 2 diabetes mellitus who participated in routine health check-ups between 2009 and 2012, with followup extending through the end of 2018. The parameters used to define the diabetes severity score encompassed diabetes duration, insulin usage, the number of oral glucose-lowering medications, the presence of chronic kidney disease, diabetic retinopathy, and cardiovascular disease. Each factor was assigned one point, yielding a cumulative severity score ranging from 0 to 6.

Results: The risk of diabetic foot amputation was predominantly predicted by insulin therapy, diabetic retinopathy, and a prolonged duration of diabetes. The hazard ratios for foot amputation increased with the severity score as follows: 2.31 (95% confidence interval [CI], 2.15 to 2.47) for a score of 1, 4.73 (95% CI, 4.42 to 5.07) for a score of 2, 8.86 (95% CI, 8.24 to 9.53) for a score of 3, 16.95 (95% CI, 15.60 to 18.4) for a score of 4, 23.98 (95% CI, 21.25 to 27.05) for a score of 5, and 37.87 (95% CI, 28.93 to 49.57) for a score of 6.

Conclusion: Specific markers of advanced diabetes effectively identified patients at an elevated risk for diabetic foot amputation.

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来源期刊
Endocrinology and Metabolism
Endocrinology and Metabolism Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
6.60
自引率
5.90%
发文量
145
审稿时长
24 weeks
期刊介绍: The aim of this journal is to set high standards of medical care by providing a forum for discussion for basic, clinical, and translational researchers and clinicians on new findings in the fields of endocrinology and metabolism. Endocrinology and Metabolism reports new findings and developments in all aspects of endocrinology and metabolism. The topics covered by this journal include bone and mineral metabolism, cytokines, developmental endocrinology, diagnostic endocrinology, endocrine research, dyslipidemia, endocrine regulation, genetic endocrinology, growth factors, hormone receptors, hormone action and regulation, management of endocrine diseases, clinical trials, epidemiology, molecular endocrinology, neuroendocrinology, neuropeptides, neurotransmitters, obesity, pediatric endocrinology, reproductive endocrinology, signal transduction, the anatomy and physiology of endocrine organs (i.e., the pituitary, thyroid, parathyroid, and adrenal glands, and the gonads), and endocrine diseases (diabetes, nutrition, osteoporosis, etc.).
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