糖尿病足部并发症和2型糖尿病的标准死亡率
Mike Stedman1, Adam Robinson2, George Dunn3
1RES Consortium, UK.
Diabetes, obesity & metabolism
|September 18, 2023
概括
脚部并发症显著增加2型糖尿病 (T2D) 患者的死亡风险. 诸如功能和白蛋白尿症等因素进一步提高了这种风险,强调了需要全面的糖尿病足部护理的需要.
科学领域:
- 糖尿病研究研究 糖尿病研究
- 临床流行病学临床流行病学
- 公共卫生 公共卫生
背景情况:
- 2型糖尿病 (T2D) 是一个全球性健康问题,具有显著的发病率和死亡率.
- 脚部并发症是T2D的常见和严重表现,导致医疗保健利用率增加和结果较差.
- 了解T2D足部并发症对死亡率的影响对于有效的风险分层和管理至关重要.
研究的目的:
- 量化T2D患者与脚部并发症相关的过度死亡率.
- 研究如何常规测量临床因素,如功能和白蛋白尿,调节T2D患者的死亡风险与脚部并发症.
主要方法:
- 一个回顾性队列研究,利用来自萨尔福德综合护理记录 (2010-2020) 的数据.
- 包括11,806名T2D患者,分析了实验室,临床数据和死亡结果.
- 标准化死亡率 (SMR_IMD) 调整为多重贫困指数 (IMD) 和估计每人死亡的生命年数 (LYLD).
主要成果:
- 总共分析了11,806名T2D患者,记录了3921例死亡.
- 患有任何足部并发症的患者 (n=2979) 与没有 (SMR_IMD 1.13) 的患者相比,死亡风险显著增加 (SMR_IMD 2.29).
- 多变量分析显示,足部并发症与阿尔伯与肌素比率升高 (≥3 mg/mmol) 或估计膜过率降低 (<60 mL/min/1.73m2) 相结合,显著增加了死亡几率 (分别为OR 1.93和1.92).
结论:
- 与没有足部并发症的T2D患者相比,T2D患者的足部并发症与死亡风险翻倍有关.
- 常规测量因素,特别是功能受损和白蛋白尿,是T2D患者患有足部并发症的死亡率增加的独立预测因素.
- 这些发现强调了积极的足部护理和对T2D并发症的管理对于减轻死亡风险至关重要.
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