超重或肥胖2型糖尿病患者糖尿病足的患病率及相关危险因素分析

Prevalence and risk factors for diabetic foot in overweight or obese type 2 diabetic patients

目的 探讨糖尿病足在超重或肥胖2型糖尿病患者中的患病率,并分析其相关危险因素.方法 2011年8月至2012年3月,从广东省内60家医院纳入2型糖尿病且合并超重或肥胖的4 037例患者作为研究对象,收集其病史、身高、体重、血糖、血脂、血肌酐、尿酸等资料,采用二分类Logistic回归分析该人群合并糖尿病足的相关危险因素.结果 本研究4 037例超重或肥胖2型糖尿病患者中,208例合并糖尿病足,糖尿病足患病率为5.2％.二分类Logistic回归分析结果显示,年龄[优势比（OR）=1.018,95％ CI：1.002～1.034）]、女性（OR=1.755,95％ CI：1.118～2.755）、糖尿病病程（OR=1.038,95％ CI：1.013 ～1.064）、体重指数（OR=1.226,95％ CI：1.157～1.299）、HbA1c（OR=1.211,95％ CI：1.135 ～ 1.293）、吸烟（OR=3.684,95％ CI：2.339～5.803）、糖尿病肾病（OR=1.514,95％ CI：1.013 ～2.263）和糖尿病周围神经病变（OR=2.250,95％ CI：1.547 ～3.273）是糖尿病足的危险因素.结论 超重或肥胖的2型糖尿病患者糖尿病足患病率较高,对于该组人群,尤其是老年女性患者,应该及时平稳控制血糖,减轻体重,避免吸烟,注意定期筛查糖尿病肾病及周围神经病变等并发症.

Objective To investigate the prevalence and risk factors for diabetic foot in overweight or obese type 2 diabetic patients.Methods From August 2011 to March 2012, 4 037 subjects who were diagnosed as type 2 diabetes and with body mass index （BMI） ≥24 kg/m^2 were enrolled from 60 hospitals in Guangdong Province.History of disease, height, weight, the level of blood glucose, lipids, creatinine and uric acid were collected.Binary Logistic regression was used to analyze the risk factors for diabetic foot.Results There were 208 patients suffered from diabetic foot in 4 037 subjects who were diagnosed as type 2 diabetes and with BMI≥24 kg/m^2.The prevalence of diabetic foot in this group was 5.2%.In the Binary Logistic regression analysis, presence of diabetic foot was positively associated with age[odd ratio （OR） =1.018,95 % CI： 1.002-1.034）] , female （OR =1.755,95 % CI： 1.118-2.755）, the duration of diabetes （OR=1.038,95% CI：1.013-1.064）, BMI（OR=1.226,95% CI：1.157-1.299）, HbA1c（OR=1.211,95% CI： 1.135-1.293） , smoking （OR =3.684,95% CI： 2.339-5.803） , diabetic nephropathy （OR =1.514,95% CI： 1.013-2.263） and diabetic neuropathy （OR =2.250,95% CI： 1.547-3.273）.Conclusions The prevalence of diabetic foot is high in overweight or obese type 2 diabetic patients.For overweight or obese type 2 diabetic patients, especially the old female patients, controlling plasma glucose,decreasing body weight, quitting smoking and screening diabetes chronic complications such as diabetic nephropathy and diabetic neuropathy are important.