{"title":"贫血与糖尿病足溃疡风险之间的关系：一项荟萃分析。","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":4.6000,"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":"{\"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\":4.6000,\"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}","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
摘要
背景：糖尿病足溃疡（DFUs）是糖尿病的主要并发症，糖尿病患者常伴有贫血。然而，贫血与发生dfu风险之间的关系尚不清楚。目的：通过荟萃分析探讨糖尿病患者贫血与DFUs风险之间的关系。方法：通过PubMed， Embase和Web of Science数据库进行系统搜索，以确定报告糖尿病患者贫血和DFUs共同发生的研究。主要结局是贫血和DFU风险之间的关联，以比值比（or）表示。次要结局包括血红蛋白每降低1 g/dL发生DFU的风险，以及有和没有DFU的患者之间血红蛋白水平的差异。采用随机效应模型进行统计分析以解释异质性。结果：16项研究共纳入170,949例糖尿病患者。结果显示贫血与DFUs风险增加之间存在显著关联(8项研究，n = 166173, OR: 2.72, 95%CI: 1.73-4.25, P < 0.001；i2 = 93%)。亚组分析支持不同患者特征、分析模型和研究质量评分之间一致的结果（P表示亚组差异，均为>.05）。此外，血红蛋白每降低1 g/dL与DFUs风险增加相关(4项研究，n = 2543, OR: 1.65, 95%CI: 1.21-2.27, P = 0.002；i2 = 68%)。此外，与没有DFUs的糖尿病患者相比，患有DFUs的糖尿病患者的血红蛋白水平显著降低(9项研究，n = 3986，平均差异：-2.13 g/dL, 95%CI: -2.58 ~ -1.68, P < 0.001；I2 = 90%)。结论：糖尿病患者贫血可能与DFUs风险增加有关。监测和管理糖尿病人群中的贫血可能有助于减轻dfu的风险，强调早期干预的必要性。需要进一步的研究来调查潜在的机制和潜在的治疗策略。
Association between anemia and the risk of diabetic foot ulcer: A meta-analysis.
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.
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