2型糖尿病患者血红蛋白与糖尿病足风险的相关性研究

Correlation between hemoglobin level and the risk of diabetic foot in type 2 diabetes patients

目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血红蛋白(hemoglobin,Hb)水平与糖尿病足(diabetic foot,DF)风险的相关性。方法选取2018年6月1日—2020年3月30日徐州医科大学附属淮安医院内分泌科住院T2DM患者145例为研究对象,根据有无并发DF将其分为DF组和non-DF组。收集患者基本资料,采血样本送本院生化中心检测生化、血常规相关指标。采用独立样本t检验、卡方检验比较2组差异;单因素二元Logistic回归分析评估各项临床指标与DF风险的相关性;多因素二元Logistic回归分析Hb与DF风险的相关性。结果DF组患者DM病程、血肌酐(Scr)、C反应蛋白(CRP)明显高于non-DF组(P<0.05),而预估肾小球滤过率(eGFR)、Hb、白蛋白(Alb)、总胆固醇(TC)则相反,明显低于non-DF组(P<0.05)。2组患者年龄、性别、体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)比较,差异无统计学意义(P>0.05)。根据eGFR水平分为eGFR≥90 ml/(min·1.73 m^(2))和eGFR<90 ml/(min·1.73 m^(2))2层,eGFR≥90 ml/(min·1.73 m^(2))层级中,Hb、Alb是DF的保护因素,Hb、Alb越低,发病率越高(P<0.05);而在eGFR<90 ml/(min·1.73 m^(2))层级中差异却无统计学意义(P<0.05)。结论T2DM患者的Hb水平是DF的保护因素,低Hb是DF患病的独立危险因素。

Objective To explore the correlation between hemoglobin(Hb)and the risk of diabetic foot(DF)in patients with type 2 diabetes mellitus(T2DM).Methods A total of T2DM 145 patients who were admitted in Department of Endocrinology,the Affiliated Huai'an Hospital of Xuzhou Medical University from June 1,2018 to March 30,2020 were enrolled.According to the presence of DF,they were divided into two groups:a DF group and a non-DF group.Their general information was obtained,while their blood samples were collected to detect biochemical and blood routine related indicators.Independent sample t test and Chi-square test were used to compare the differences between the two groups.Univariate logistic regression analysis was performed to evaluate the correlation between various clinical indicators and DF risks.Multivariate logistic regression analysis was used to analyze the correlation between Hb level and DF risk.Results The DF group presented remarkable increases in diabetes duration,serum creatinine(Scr),and C-reactive protein(CRP)(P<0.05),as well as the estimated glomerular filtration rate(eGFR),Hb,albumin(Alb)and total cholesterol(TC)(P<0.05),compared with the non-DF group.There were no significant differences in age,gender,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),hemoglobin A1c(HbA1c),fasting blood glucose(FPG),triacylglycerol(TG),low density lipoprotein cholesterol(LDL-C),and high density lipoprotein cholesterol(HDL-C)(P>0.05).According to eGFR level,the patients were divided into two groups:eGFR≥90 ml/(min·1.73 m^(2))and eGFR<90 ml/(min·1.73 m^(2)).For those with eGFR≥90 ml/(min·1.73 m^(2)),Hb and Alb were the two protective factors of DF;the lower Hb and Alb were,the higher the incidence of DF was(P<0.05).However,no statistical difference was found in the group whose eGFR was less than 90 ml/(min·1.73 m^(2))(P>0.05).Conclusions The Hb level of T2DM patients is a protective factor of DF and a low Hb is an independent risk factor of DF.