Medial Arterial Calcification and the Risk of Amputation of Diabetic Foot Ulcer in Patients With Diabetic Kidney Disease.

Autor:	So JM; College of Medicine, Yeungnam University, Daegu, Korea., Park JH; College of Medicine, Yeungnam University, Daegu, Korea., Kim JG; College of Medicine, Yeungnam University, Daegu, Korea., Park IR; Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea., Ha EY; Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea., Chung SM; Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea. smchung@ynu.ac.kr., Moon JS; Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea. mjs7912@yu.ac.kr., Park CH; Department of Orthopedic Surgery, Yeungnam University College of Medicine, Daegu, Korea., Yun WS; Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea., Kim TG; Department of Plastic Surgery, Yeungnam University College of Medicine, Daegu, Korea., Kim W; Division of Cardiology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea., Yoon JS; Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea., Won KC; Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea., Lee HW; Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
Jazyk:	angličtina
Zdroj:	Journal of Korean medical science [J Korean Med Sci] 2023 May 29; Vol. 38 (21), pp. e160. Date of Electronic Publication: 2023 May 29.
DOI:	10.3346/jkms.2023.38.e160
Abstrakt:	We assessed the risk factors for major amputation of diabetic foot ulcers (DFUs) in patients with diabetic kidney disease (DKD) stages 3b-5. For DFU assessment, in addition to DFU location and presence of infection, ischemia, and neuropathy, vascular calcification was assessed using the medial arterial calcification (MAC) score. Of 210 patients, 26 (12.4%) underwent major amputations. Only the location and extension of DFU, represented by Texas grade differed between the minor and major amputation groups. However, after adjusting for covariates, ulcer location of mid- or hindfoot (vs. forefoot, odds ratio [OR] = 3.27), Texas grades 2 or 3 (vs. grade 0, OR = 5.78), and severe MAC (vs. no MAC, OR = 4.46) was an independent risk factor for major amputation (all P < 0.05). The current use of antiplatelets was a possible protective factor for major amputations (OR = 0.37, P = 0.055). In conclusion, DFU with severe MAC is associated with major amputation in patients with DKD. Competing Interests: The authors have no potential conflicts of interest to disclose. (© 2023 The Korean Academy of Medical Sciences.)
Databáze:	MEDLINE
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