老年2型糖尿病病人血清铁蛋白水平与糖尿病足发生的相关性

doi:10.3969/j.issn.1003-9198.2023.11.008

摘要/Abstract

摘要： 目的探究老年T2DM病人血清铁蛋白(SF)水平与糖尿病足(DF)发生的相关性及阈值效应。方法回顾性分析2019年8月至2022年4月宿州市立医院收治的108例老年T2DM病人临床资料,根据是否合并DF,分为DF组(48例)和无DF组(NDF组,60例)。曲线拟合分析SF水平与DF发生风险的相关性,并通过阈值效应分析找到截断值。采用多因素Logistic回归分析危险因素。采用ROC曲线评估各指标的预测效能。结果当SF>570 ng/mL时,随着SF水平升高,DF发生风险呈上升趋势(OR=0.975,95%CI:0.860~0.998,P<0.01)。HbA1c>9.5%、TC>5.5 mmol/L、血肌酐(Scr)>97.0 μmol/L、估算的肾小球滤过率(eGFR)≤70.0 mL/(min·1.73 m²)、SF>570.0 ng/mL以及糖尿病肾病(DN),均为DF发生的独立危险因素(P<0.05)。ROC曲线分析结果显示,HbA1c、TC、Scr、eGFR、SF以及DN预测DF发生的效能均较高,其中SF最高。结论随着SF水平升高,DF发生风险呈上升趋势。SF对于DF的发生具有较高的预测效能。临床医护人员应重点关注,以期改善病人预后。

关键词: 2型糖尿病, 血清铁蛋白, 糖尿病足, 相关性

Abstract: Objective To explore the correlation between serum ferritin (SF) levels and diabetic foot (DF) in the elderly patients with type 2 diabetes mellitus (T2DM). Methods The clinical data of 108 elderly T2DM patients admitted to Suzhou Municipal Hospital from August 2019 to April 2022 were analyzed retrospectively. All the patients were divided into DF group (n=48) and non-DF group (NDF, n=60). The correlation between SF level and DF risk was analyzed by curve fitting, and the cut-off value was defined by threshold effect analysis. Multiple Logistic regression analysis was used to analyze the risk factors for DF. Receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of each indicator. Results When SF was>570 ng/mL, the risk of DF increased with the increase of SF (OR=0.975, 95%CI: 0.860-0.998, P<0.01). Glycosylated hemoglobin(HbA1c)>9.5%, total cholesterol(TC)>5.5 mmol/L, serum creatinine(Scr)>97.0 μmol/L, eGFR(estimated glomerular filtration rate)≤70.0 mL/(min·1.73 m²), SF>570.0 ng/mL and diabetic nephropathy(DN) were independent risk factors for DF (P<0.05). The ROC curve analysis showed that HbA1c, TC, Scr, eGFR, SF and DN were all highly effective indicators in predicting DF, of which SF showed the best efficiency. Conclusions As SF level increases, the risk of DF shows an upward trend. SF shows good predictive efficiency for the occurrence of DF. It is important to focus on SF in clinic to improve the patients' prognosis.

Key words: type 2 diabetes mellitus, serum ferritin, diabetic foot, correlation

中图分类号:

R 587.1

张贺成, 魏苏. 老年2型糖尿病病人血清铁蛋白水平与糖尿病足发生的相关性[J]. 实用老年医学, 2023, 37(11): 1111-1114.

ZHANG He-cheng, WEI Su. Correlation of serum ferritin level with diabetic foot in elderly patients with type 2 diabetes mellitus[J]. Practical Geriatrics, 2023, 37(11): 1111-1114.

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