Analysis Of Clinical Risk Factors In Diabetic Foot

Objective To investigate the risk factors of diabetic foot in classificationand grading.Method Selected type2diabetic foot hospitalized patients ofEndocrinology Department of The First Affiliated Hospital of Guangxi MedicalUniversity from January2008to December2012as research subject, and at thesame time also selected type2diabetes non-diabetic foot patients as controlgroup, then type2diabetic foot patients were divided into ischemic，neuropathicand mixed(neuro-ischemic) diabetic foot groups, and were divided again intomild and severe diabetic foot subgroups, compared their clinical records andlaboratory test, used logistic regression analysis to analyzed the risk factors.Result①Among82diabetic foot patients,52patients were male,30patients were female,74.1%of the patients aged>50years old,65.9%ofpatients with diabetes duration of more than five years, smokers accounted for31.7%. Most of the patients had diabetes complications, carotid artery diseaseaccounted for58.5%,82.9%of lower extremities arterial vascular disease,peripheral neuropathy accounted for75.6%,34.1%of diabetic nephropathy, anddiabetic retinopathy accounted for48.8%. Some patients had complications,hypertension63.4%, coronary heart disease4.9%, cerebral infraction17.1%.95.1%of the patients with glycosylated hemoglobin (HbA1c)>7%.② Comparison between groups: diabetic foot (with/without) comparison betweengroups, diabetic foot group’s age, with carotid atherosclerosis, lower extremitiesarteriosclerosis, peripheral neuropathy, diabetic neuropathy, diabetic retinopathy,with hypertension, cerebral infraction, glycosylated hemoglobin (HbA1c), thehomocysteine (Hcy), lipoprotein a (LP-a), white blood cells (WBC), platelet(Plt), platelet hematocrit (PCT), and24hours urine albumin were increasedcompare to non-diabetic foot group (control group),(P <0.05), the albumin(ALB), hemoglobin (Hb), hematocrit (HCT), total cholesterol (TC) weredecreased compare to non-diabetic foot group (control group),(P <0.05); thebody mass index (BMI), total protein (TP), high density lipoprotein (HDL-C),low density lipoprotein (LDL-C), and triglyceride (TG) had no statiscticaldifference,(P>0.05). Diabetic foot types (neuropathic diabetic foot，ischemicdiabetic foot and mixed diabetic foot) comparison between groups, three groupsdiabetic foot with carotid atherosclerosis, diabetic retinopathy, hypertension,coronary heart disease, cerebral infraction, the homocysteine (Hcy) hadstatisctical difference (P<0.05). No statistical difference was found between therest indicators. Diabetic foot indexing (mild/severe) comparison between groups,severe type (Wagner grade3-5) patient’s serum albumin (ALB), high senditylipoprotein (HDL-C), hemoglobin (Hb) were lower than mild type (Wagnergrade1-2) patient (P <0.05), but the white blood cell (WBC), platelet count (Plt),platelet hematocrit (PCT) were higher than mild type patient (P<0.05). Nostatistical difference was found between the rest indicators. Used univariate andbinarary logistic regression to analyzed the risk factors, elevated glycosylatedhemoglobin (HbA1c), hyperhomocysteinemia, and elevated white blood cell(WBC) was the risk factors of diabetic foot, hyperhomocysteinemia was the riskfactor of ischemic diabetic foot, and elevated white blood cells was the risk factor of severe diabetic foot.Conclusion Diabetic foot occurred in poor glycemic control, over50yearsof age, on multiple complications of diabetes patients, hyperhomocysteinemiaand diabetic foot incidence were associated, related with ischemic diabetic foot,was the risk factors of diabetic foot as well as ischemic diabetic foot.Leukocytosis was the risk factor for diabetic foot occurrence and severity.