The 14-year incidence of lower-extremity amputations in a diabetic population - The Wisconsin Epidemiologic Study of Diabetic Retinopathy

被引:115
作者
Moss, SE [1 ]
Klein, R [1 ]
Klein, BEK [1 ]
机构
[1] Univ Wisconsin, Dept Ophthalmol & Visual Sci, Sch Med, Madison, WI 53705 USA
关键词
D O I
10.2337/diacare.22.6.951
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE - To estimate the cumulative 14-year incidence of lower-extremity amputations (LEAs) and evaluate risk factors for LEA. RESEARCH DESIGN AND METHODS - Study subjects consisted of population-based cohorts of younger-onset (diagnosed before age 30 years and taking insulin, n = 906) and older-onset (diagnosed after age 30 years, n = 984) individuals with diabetes. Subjects participated in baseline (1980-1982), 4-year, 10-year and 14-year examinations or interviews. LEAs were determined by history. RESULTS - The cumulative 14-year incidence of LEA was 7.2% in younger- and 9.9% in older-onset patients. In multivariable analyses based on the discrete linear logistic model, LEA in the younger-onset group was more likely for males (odds ratio [OR] 5.21 [95% CI 2.50-10.88]), older age (OR for 10 years 1.71 [1.30-2.24]), higher glycosylated hemoglobin (OR for 1% 1.39 [1.22-1.59]), higher diastolic blood pressure (OR for 10 mmHg 1.58 [1.20-2.07]), history of ulcers of the feet (3.19 [1.71-5.95]), and more severe retinopathy (OR for one step 1.16 [1.08-1.24]). In younger-onset patients aged greater than or equal to 18, pack-years smoked (OR for 10 years 1.20 [1.03-1.41]) was also associated with LEAs, and daily aspirin use was inversely associated (OR 0.11 [0.01-0.83]). In the older-onset group, LEA was more likely for men (2.66 [1.49, 4.76]) and if the subject had higher glycosylated hemoglobin (OR for 1% 1.25 [1.09-1.43]), higher pulse pressure (OR for 10 mmHg 1.19 [1.04-1.37]), history of ulcers (3.56 [1.84-6.89]), and more severe retinopathy (OR for one step 1.07 [1.00-1.13]). CONCLUSIONS - There are several risk factors for LEA with potential for modification and preventive strategies.
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页码:951 / 959
页数:9
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共 57 条
[1]  
ABELL LL, 1952, J BIOL CHEM, V195, P357
[2]   Risk factors for diabetic peripheral sensory neuropathy - Results of the Seattle Prospective Diabetic Foot Study [J].
Adler, AI ;
Boyko, EJ ;
Ahroni, JH ;
Stensel, V ;
Forsberg, RC ;
Smith, DG .
DIABETES CARE, 1997, 20 (07) :1162-1167
[3]  
Armstrong D G, 1997, J Foot Ankle Surg, V36, P66
[4]   Alcohol and the NIDDM patient [J].
Bell, DSH .
DIABETES CARE, 1996, 19 (05) :509-513
[5]  
CAMERON HC, 1964, LANCET, V2, P605
[6]   EFFECTS OF ASPIRIN ON VITREOUS PRERETINAL HEMORRHAGE IN PATIENTS WITH DIABETES-MELLITUS - EARLY TREATMENT DIABETIC-RETINOPATHY STUDY REPORT NO-20 [J].
CHEW, EY ;
KLEIN, ML ;
MURPHY, RP ;
REMALEY, NA ;
FERRIS, FL .
ARCHIVES OF OPHTHALMOLOGY, 1995, 113 (01) :52-55
[7]   Aspirin therapy in diabetes [J].
不详 .
DIABETES CARE, 1997, 20 (11) :1772-1773
[8]   A SURVEY OF LOWER-LIMB AMPUTATION IN DIABETIC-PATIENTS [J].
DEEROCHANAWONG, C ;
HOME, PD ;
ALBERTI, KGMM .
DIABETIC MEDICINE, 1992, 9 (10) :942-946
[9]  
DESTEFANO F, 1990, DIABETES SURVEILLANC, P23
[10]   CHARACTERIZATION OF 7 C-PEPTIDE ANTISERA [J].
FABER, OK ;
BINDER, C ;
MARKUSSEN, J ;
HEDING, LG ;
NAITHANI, VK ;
KUZUYA, H ;
BLIX, P ;
HORWITZ, DL ;
RUBENSTEIN, AH .
DIABETES, 1978, 27 :170-177