Higher systemic inflammatory status and cardiovascular risk associated with Charcot arthropathy unrelated to
Jessica Castro de Vasconcelos1, Yeelen Ballesteros Atala1, Denise Engelbrecht Zantut-Wittmann1
1Endocrinology Division, Department of Internal Medicine (Endocrinology), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo Brazil.
Insights
People with type 2 diabetes and Charcot arthropathy face higher mortality, not solely due to infections. This study reveals increased cardiovascular risk and systemic inflammation in these patients, suggesting other contributing factors to their mortality risk.
Area of Science:
- Endocrinology
- Diabetology
- Cardiology
- Rheumatology
Background:
- Individuals with diabetes and Charcot arthropathy exhibit elevated mortality rates compared to those with diabetes alone.
- The underlying causes for this increased mortality are debated, with potential links to infectious or cardiovascular origins.
Purpose of the Study:
- To investigate cardiovascular risk factors and systemic inflammation in type 2 diabetes patients with and without Charcot arthropathy.
- To determine if elevated mortality in diabetic patients with Charcot arthropathy is associated with factors beyond infection.
Main Methods:
- A cross-sectional study involving 69 participants with type 2 diabetes, categorized into three groups: with Charcot arthropathy, with diabetic peripheral neuropathy, and without neuropathy.
- Participants underwent clinical and laboratory evaluations, with cardiovascular risk assessed using the United Kingdom Prospective Diabetes Study (UKPDS) calculator.
- Matching for sex and age was performed, and participants with active infections were excluded.
Main Results:
- Patients with Charcot arthropathy (n=21) had a longer diabetes duration, higher incidence of dyslipidemia, and elevated levels of uric acid, microalbuminuria, and C-reactive protein compared to control groups (n=24 each).
- A significant proportion (73.9%) of all participants presented with high or very high cardiovascular risk based on the UKPDS score.
- Systemic inflammatory markers were notably higher in patients with Charcot arthropathy, even in the chronic stage of the condition.
Conclusions:
- Type 2 diabetes patients with Charcot arthropathy demonstrate heightened systemic inflammation and cardiovascular risk, irrespective of active infection.
- These inflammatory and cardiovascular factors likely contribute to the increased mortality observed in this patient population, suggesting causes beyond infection.
Purpose:
People with diabetes and Charcot arthropathy have higher mortality than people with diabetes without this complication. Are the causes of this higher mortality exclusively infectious or of a cardiovascular origin? We aimed to study aspects related to cardiovascular risk and inflammation in a population of people with type 2 diabetes with and without Charcot arthropathy.
Methods:
A cross-sectional study was performed in people with diabetes and Charcot Eickenholtz III arthropathy, matched for sex and age, with two groups of people with diabetes without Charcot arthropathy with and without peripheral sensory-motor neuropathy, in the absence of active infection. All participants underwent clinical and laboratory evaluation at the time of the interview, and their cardiovascular risk was calculated according to the United Kingdom Prospective Diabetes Study (UKPDS) calculator.
Results:
We evaluated 69 people with type 2 diabetes (21 with Charcot arthropathy, 24 with diabetic peripheral neuropathy and 24 without this neuropathy), with a mean age between 57 and 61 years and with a diabetes duration of more than 10 years. Patients with Charcot arthropathy had a longer duration of diabetes; more frequency of dyslipidemia; and higher levels of uric acid, microalbuminuria and C-reactive protein than the other two groups. A total of 73.9% of the people evaluated had high or very high cardiovascular risk according to the UKPDS score.
Conclusion:
The people with type 2 diabetes presenting Charcot arthropathy had greater values of systemic inflammatory parameters, even in the chronic phase of the complication, with a higher risk of mortality unrelated to infections.
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