Risk factors for at-risk foot and peripheral artery disease among the population with diabetes: A multicommunity-based cross-sectional study

Bichen Ren; Bingzhe Li; Tianyue Pan; Enhui Zhao; Shuai Ju; Xiaoyan Li; Xiaomu Li; Yizhun Zhu; Yunmin Cai; Lihong Huang; Weiguo Fu; Zhihui Dong

doi:10.1016/j.diabres.2023.110869

Risk factors for at-risk foot and peripheral artery disease among the population with diabetes: A multicommunity-based cross-sectional study

Diabetes Res Clin Pract. 2023 Sep:203:110869. doi: 10.1016/j.diabres.2023.110869. Epub 2023 Aug 8.

Authors

Bichen Ren¹, Bingzhe Li², Tianyue Pan¹, Enhui Zhao³, Shuai Ju⁴, Xiaoyan Li⁴, Xiaomu Li⁵, Yizhun Zhu⁶, Yunmin Cai⁴, Lihong Huang⁷, Weiguo Fu⁸, Zhihui Dong⁹

Affiliations

¹ Department of Vascular Surgery, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China; National Clinical Research Center for Interventional Medicine, Zhongshan-Jinshan Diabetic Foot Center, Shanghai 200032, China.
² Department of Biostatistics, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
³ School of Public Health, Fudan University, Shanghai 200032, China.
⁴ National Clinical Research Center for Interventional Medicine, Zhongshan-Jinshan Diabetic Foot Center, Shanghai 200032, China; Department of Vascular and Wound Treatment Center, Jinshan Hospital, Fudan University, Shanghai 200540, China.
⁵ Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
⁶ State Key Laboratory of Quality Research in Chinese Medicine and School of Pharmacy, Macau University of Science and Technology, Macau.
⁷ Department of Biostatistics, Zhongshan Hospital, Fudan University, Shanghai 200032, China. Electronic address: huang.lihong@zs-hospital.sh.cn.
⁸ Department of Vascular Surgery, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China; National Clinical Research Center for Interventional Medicine, Zhongshan-Jinshan Diabetic Foot Center, Shanghai 200032, China. Electronic address: fu.weiguo@zs-hospital.sh.cn.
⁹ Department of Vascular Surgery, Institute of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China; National Clinical Research Center for Interventional Medicine, Zhongshan-Jinshan Diabetic Foot Center, Shanghai 200032, China. Electronic address: dzh926@126.com.

PMID: 37562660
DOI: 10.1016/j.diabres.2023.110869

Abstract

Aims: This study aimed to investigate the prevalence, characteristics, and influence factors of the at-risk foot with diabetes mellitus (DM).

Methods: This study included 3030 DM patients from the at-risk foot screening program of Shanghai in China between March 21 and April 30 in 2021. Data were collected from the questionnaire survey, physical examination, and fasting blood sample.

Results: The prevalence of at-risk foot was 27.8% among DM patients. After adjusted, the risk of higher at-risk grade increased with age and urinary albumin creatinine ratio (OR = 1.04, 95%CI = 1.02-1.06; OR = 1.001, 95%CI = 1.000-1.002, respectively), whereas decreased with estimated glomerular filtration rate (eGFR) (OR = 0.991, 95%CI = 0.984-0.998). The incidence of peripheral artery disease (PAD) was 11.1% in all people with DM, and age, pulse rate, and low-density lipoprotein were independent risk factors for PAD. In contrast, high-density lipoprotein, eGFR, and lymphocyte-to-monocyte ratio were independent protective factors for PAD. Glycated hemoglobin HbA1c was not an independent risk factor for increased risk grade or more severe PAD.

Conclusions: The at-risk foot accounted for a high percentage among DM patients. Advanced age and renal dysfunction are independent risk factors for the at-risk foot. Glycemic control does not reduce the risk grade of at-risk foot and the incidence of PAD.

Keywords: Diabetic foot, at-risk foot; Glycemic control; Peripheral artery disease; Renal function.