Baseline characteristics and risk factors for ulcer, amputation and severe neuropathy in diabetic foot at risk: the BRAZUPA study.

Autor: Parisi MC; Faculty of Medical Sciences, State University of Campinas, Campinas, SP 13083-887 Brazil ; Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil., Moura Neto A; Faculty of Medical Sciences, State University of Campinas, Campinas, SP 13083-887 Brazil., Menezes FH; Faculty of Medical Sciences, State University of Campinas, Campinas, SP 13083-887 Brazil., Gomes MB; Unity of Diabetes, State University of Rio de Janeiro, Rio de Janeiro, Brazil., Teixeira RM; Unity of Diabetes, State University of Rio de Janeiro, Rio de Janeiro, Brazil., de Oliveira JE; Department of Nutrology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil., Pereira JR; Department of Nutrology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil., Fonseca RM; Centre for Diabetes and Endocrinology in the State of Bahia (CEDEBA), Salvador, Brazil., Guedes LB; Centre for Diabetes and Endocrinology in the State of Bahia (CEDEBA), Salvador, Brazil., Costa E Forti A; Centro Integrado de diabetes e Hipertensão do Ceará, Fortaleza, Brazil., de Oliveira AM; State University of Feira de Santana, Feira de Santana, Brazil., de Medeiros Nóbrega MB; Federal University of Campina Grande, Campina Grande, Brazil., Colares VN; Federal University of Campina Grande, Campina Grande, Brazil., Schmid H; Hospital das Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS Brazil ; Santa Casa de Porto Alegre, Porto Alegre, RS Brazil., Nienov OH; Hospital das Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS Brazil ; Santa Casa de Porto Alegre, Porto Alegre, RS Brazil., Nery M; Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil., Fernandes TD; Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil., Pedrosa HC; Hospital Regional de Taguatinga, Brasília, Brazil., Schreiber de Oliveira Cda S; Faculdade de Medicina, Federal University of Santa Catarina, Florianopolis, Brazil., Ronsoni M; Faculdade de Medicina, Federal University of Santa Catarina, Florianopolis, Brazil., Rezende KF; Federal University of Sergipe, São Cristóvão, Brazil., Quilici MT; Pontifícia Universidade Católica de Sorocaba, Sorocaba, Brazil., Vieira AE; Pontifícia Universidade Católica de Sorocaba, Sorocaba, Brazil., de Macedo GM; Division of Endocrinology, Hospital Agamenon Magalhães, Recife, Brazil., Stuchi-Perez EG; Faculdade de Medicina de Catanduva, Catanduva, Brazil., Dinhane KG; Faculdade de Medicina de Botucatu, UNESP, Botucatu, Brazil., Pace AE; Universidade de São Paulo, Faculdade de Medicina, Ribeirão Preto, Brazil., de Freitas MC; Universidade de São Paulo, Faculdade de Medicina, Ribeirão Preto, Brazil., Calsolari MR; Santa Casa de Belo Horizonte, Belo Horizonte, Brazil., Saad MJ; Faculty of Medical Sciences, State University of Campinas, Campinas, SP 13083-887 Brazil.
Jazyk: angličtina
Zdroj: Diabetology & metabolic syndrome [Diabetol Metab Syndr] 2016 Mar 17; Vol. 8, pp. 25. Date of Electronic Publication: 2016 Mar 17 (Print Publication: 2016).
DOI: 10.1186/s13098-016-0126-8
Abstrakt: Background: Studies on diabetic foot and its complications involving a significant and representative sample of patients in South American countries are scarce. The main objective of this study was to acquire clinical and epidemiological data on a large cohort of diabetic patients from 19 centers from Brazil and focus on factors that could be associated with the risk of ulcer and amputation.
Methods: This study presents cross sectional, baseline results of the BRAZUPA Study. A total of 1455 patients were included. Parameters recorded included age, gender, ethnicity, diabetes and comorbidity-related records, previous ulcer or amputation, clinical symptomatic score, foot classification and microvascular complications.
Results: Patients with ulcer had longer disease duration (17.2 ± 9.9 vs. 13.2 ± 9.4 years; p < 0.001), and poorer glycemic control (HbA1c 9.23 ± 2.03 vs. 8.35 ± 1.99; p < 0.001). Independent risk factors for ulcer were male gender (OR 1.71; 95 % CI 1.2-3.7), smoking (OR 1.78; 95 % CI 1.09-2.89), neuroischemic foot (OR 20.34; 95 % CI 9.31-44.38), region of origin (higher risk for those from developed regions, OR 2.39; 95 % CI 1.47-3.87), presence of retinopathy (OR 1.68; 95 % CI 1.08-2.62) and absence of vibratory sensation (OR 7.95; 95 % CI 4.65-13.59). Risk factors for amputation were male gender (OR 2.12; 95 % CI 1.2-3.73), type 2 diabetes (OR 3.33; 95 % CI 1.01-11.1), foot at risk classification (higher risk for ischemic foot, OR 19.63; 95 % CI 3.43-112.5), hypertension (lower risk, OR 0.3; 95 % CI 0.14-0.63), region of origin (South/Southeast, OR 2.2; 95 % CI 1.1-4.42), previous history of ulcer (OR 9.66; 95 % CI 4.67-19.98) and altered vibratory sensation (OR 3.46; 95 % CI 1.64-7.33). There was no association between either outcome and ethnicity.
Conclusions: Ulcer and amputation rates were high. Age at presentation was low and patients with ulcer presented a higher prevalence of neuropathy compared to ischemic foot at risk. Ischemic disease was more associated with amputations. Ethnical differences were not of great importance in a miscegenated population.
Databáze: MEDLINE
Externí odkaz: