1
|
Tang WH, Zhao YN, Cheng ZX, Xu JX, Zhang Y, Liu XM. Risk factors for diabetic foot ulcers: A systematic review and meta-analysis. Vascular 2024; 32:661-669. [PMID: 36740805 DOI: 10.1177/17085381231154805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To systematically evaluate the risk factors for developing diabetic foot ulcers (DFU). METHODS The Cochrane Library, PubMed, Web of Science, SinoMed, CNKI, VIP, and Wanfang Data were searched for relevant studies on DFU risk factors, and the search time frame was from database creation to March 2022. Meta-analysis was performed using RevMan 5.3. RESULTS A total of 26 publications were included, including 3 cohort studies, 22 case-control studies, and one cross-sectional study. Meta-analysis showed that advanced age [MD = 6.04, 95% CI (3.92, 8.16)], male [OR = 1.84, 95% CI (1.48, 2.29)], elevated body mass index [MD = 1.58, 95% CI (0.47, 2.69)], prolonged duration of diabetes [MD = 2.72, 95% CI (2.33, 3.11)], comorbid nephropathy [OR = 3.15, 95% CI (2.68, 4.60)], comorbid neuropathy [OR = 4.80, 95% CI (2.79, 8.27)], comorbid retinopathy [OR = 3.37, 95% CI (2.26, 5.02)], elevated systolic blood pressure [OR = 8.19, 95% CI (6.33, 10.05)], elevated fasting glucose [MD = 1.60, 95% CI (0.21, 3.00)], elevated glycated hemoglobin [MD = 1.24, 95% CI (0.94, 1.54)], elevated triglycerides [MD = 0.44 (95% CI (0.15, 0.73)], elevated fibrinogen [MD = 1.35, 95% CI (0.62, 2.08)], elevated white blood cell count [MD = 2.56, 95% CI (2.24, 2.88)], elevated C-reactive protein [MD = 15.08, 95% CI (8.03, 22.13)], decreased ankle-brachial ratio [MD = -0.26, 95% CI (-0.36, -0.16)], and decreased total protein levels [MD = -4.58, 95% CI (-6.91, -2.25)] were risk factors for developing DFU (p < 0.05), and increased HDL cholesterol levels [MD = -0.22, 95% CI (-0.36, -0.08)] were protective factor for developing DFU (p < 0.05). CONCLUSION There are many risk factors for developing of ulcers in the diabetic feet, and early prevention and intervention should be performed as early as possible to assess the risk of developing diabetic foot patients.
Collapse
Affiliation(s)
- W H Tang
- First School of Clinical Medicine, Shandong University of Traditional Chinese Medicine, China
| | - Y N Zhao
- Department of Peripheral Vascular Disease, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, China
| | - Z X Cheng
- Department of Peripheral Vascular Disease, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, China
| | - J X Xu
- First School of Clinical Medicine, Shandong University of Traditional Chinese Medicine, China
| | - Y Zhang
- Department of Peripheral Vascular Disease, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, China
| | - X M Liu
- Department of Peripheral Vascular Disease, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, China
| |
Collapse
|
2
|
Lee SH, Kim SH, Kim KB, Kim HS, Lee YK. Factors Influencing Wound Healing in Diabetic Foot Patients. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:723. [PMID: 38792906 PMCID: PMC11122953 DOI: 10.3390/medicina60050723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/19/2024] [Accepted: 04/25/2024] [Indexed: 05/26/2024]
Abstract
Background and objectives: Diabetic foot stands out as one of the most consequential and devastating complications of diabetes. Many factors, including VIPS (Vascular management, Infection management, Pressure relief, and Source of healing), influence the prognosis and treatment of diabetic foot patients. There are many studies on VIPS, but relatively few studies on "sources of healing". Nutrients that affect wound healing are known, but objective data in diabetic foot patients are insufficient. We hypothesized that "sources of healing" would have many effects on wound healing. The purpose of this study is to know the affecting factors related to the source of healing for diabetic foot patients. Materials and Methods: A retrospective review identified 46 consecutive patients who were admitted for diabetic foot management from July 2019 to April 2021 at our department. Several laboratory tests were performed for influencing factor evaluation. We checked serum levels of total protein, albumin, vitamin B, iron, zinc, magnesium, copper, Hb, HbA1c, HDL cholesterol, and LDL cholesterol. These values of diabetic foot patients were compared with normal values. Patients were divided into two groups based on wound healing rate, age, length of hospital stay, and sex, and the test values between the groups were compared. Results: Levels of albumin (37%) and Hb (89%) were low in the diabetic foot patients. As for trace elements, levels of iron (97%) and zinc (95%) were low in the patients, but levels of magnesium and copper were usually normal or high. There were no differences in demographic characteristics based on wound healing rate. However, when compared to normal adult values, diabetic foot patients in our data exhibited significantly lower levels of hemoglobin, total protein, albumin, iron, zinc, copper, and HDL cholesterol. When compared based on age and length of hospital stay, hemoglobin levels were significantly lower in both the older age group and the group with longer hospital stays. Conclusions: Serum levels of albumin, Hb, iron, and zinc were very low in most diabetic foot patients. These low values may have a negative relationship with wound healing. Nutrient replacements are necessary for wound healing in diabetic foot patients.
Collapse
Affiliation(s)
- Sang Heon Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Gyeonggi-do, Republic of Korea; (S.H.L.); (S.H.K.); (H.S.K.)
| | - Sung Hwan Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Gyeonggi-do, Republic of Korea; (S.H.L.); (S.H.K.); (H.S.K.)
| | - Kyung Bum Kim
- Department of Orthopaedic Surgery, NEW Korea Hospital, 283, Gimpohangang 3-ro, Gimpo-si 10086, Gyeonggi-do, Republic of Korea;
| | - Ho Sung Kim
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Gyeonggi-do, Republic of Korea; (S.H.L.); (S.H.K.); (H.S.K.)
| | - Young Koo Lee
- Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Gyeonggi-do, Republic of Korea; (S.H.L.); (S.H.K.); (H.S.K.)
| |
Collapse
|
3
|
Kotronoulas A, de Lomana ALG, Einarsdóttir HK, Kjartansson H, Stone R, Rolfsson Ó. Fish Skin Grafts Affect Adenosine and Methionine Metabolism during Burn Wound Healing. Antioxidants (Basel) 2023; 12:2076. [PMID: 38136196 PMCID: PMC10741162 DOI: 10.3390/antiox12122076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
Burn wound healing is a complex process orchestrated through successive biochemical events that span from weeks to months depending on the depth of the wound. Here, we report an untargeted metabolomics discovery approach to capture metabolic changes during the healing of deep partial-thickness (DPT) and full-thickness (FT) burn wounds in a porcine burn wound model. The metabolic changes during healing could be described with six and seven distinct metabolic trajectories for DPT and FT wounds, respectively. Arginine and histidine metabolism were the most affected metabolic pathways during healing, irrespective of burn depth. Metabolic proxies for oxidative stress were different in the wound types, reaching maximum levels at day 14 in DPT burns but at day 7 in FT burns. We examined how acellular fish skin graft (AFSG) influences the wound metabolome compared to other standard-or-care burn wound treatments. We identified changes in metabolites within the methionine salvage pathway, specifically in DPT burn wounds that is novel to the understanding of the wound healing process. Furthermore, we found that AFSGs boost glutamate and adenosine in wounds that is of relevance given the importance of purinergic signaling in regulating oxidative stress and wound healing. Collectively, these results serve to define biomarkers of burn wound healing. These results conclusively contribute to the understanding of the multifactorial mechanism of the action of AFSG that has traditionally been attributed to its structural properties and omega-3 fatty acid content.
Collapse
Affiliation(s)
- Aristotelis Kotronoulas
- Center for Systems Biology, Medical Department, University of Iceland, Sturlugata 8, 102 Reykjavik, Iceland
| | | | | | | | - Randolph Stone
- US Army Institute of Surgical Research, JBSA Fort Sam Houston, TX 78234, USA
| | - Óttar Rolfsson
- Center for Systems Biology, Medical Department, University of Iceland, Sturlugata 8, 102 Reykjavik, Iceland
| |
Collapse
|
4
|
Atoum MF, Al Shdaifat A, Al Hourani H, Al Hyari M, Zahran R, Abu Shaikh H. Relationship of Serum Vitamin D Levels With Diabetic Foot in Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Study. INT J LOW EXTR WOUND 2023:15347346231205641. [PMID: 37792565 DOI: 10.1177/15347346231205641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Background and aims: Diabetic foot is one of the most severe complications in patients with diabetes mellitus and has been linked to 25-OH-vitamin D status. This study aims to determine the prevalence of 25-OH-vitamin D deficiency and its association with diabetic foot. Methods: Patients with type 2 diabetes mellitus were enrolled in this study. The patients were divided into the diabetic foot group (n = 95) and the non-diabetic foot group (n = 388). Weight, height, and waist circumference were measured. The 25-OH-vitamin D and the other biochemical tests were extracted from the electronic medical records. The difference in clinical parameters between the diabetic foot group and the non-diabetic foot group was analyzed, and the risk factors of the diabetic foot group were analyzed using logistic regression. Results: The prevalence of 25-OH-vitamin D deficiency was 44.6%, accounting for 57.9% of all the diabetic foot group patients and only 41.0% of the non-diabetic foot group patients. The mean serum 25-OH-vitamin D level was significantly different between the diabetic foot group and the non-diabetic foot group (19.8 ± 9.5 vs 24.1 ± 11.8; P = .011). Serum 25-OH-vitamin D and B12 were found to have a significant positive correlation (r = 0.410, P = <.01). The 25-OH-vitamin D level and body mass index were independently associated with diabetic foot (P = .043, OR = 1.21; P = .009, OR = 1.47), respectively. Conclusions: The 25-OH-vitamin D deficiency was higher in the diabetic foot group. More research is needed to understand the role of 25-OH-vitamin D in the development of diabetic foot.
Collapse
Affiliation(s)
- Manar Fayiz Atoum
- Department of Medical Laboratory Sciences, Faculty of Applied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Amjad Al Shdaifat
- Department of Internal and Family Medicine, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Huda Al Hourani
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Muwafag Al Hyari
- Center of Diabetes and Endocrinology, Prince Hamza Hospital, Diabetic Center, Amman, Jordan
| | - Reema Zahran
- Center of Diabetes and Endocrinology, Prince Hamza Hospital, Diabetic Center, Amman, Jordan
| | | |
Collapse
|
5
|
Apergi K, Dimosthenopoulos C, Papanas N. The Role of Nutrients and Diet Characteristics in the Management of Diabetic Foot Ulcers: A Systematic Review. INT J LOW EXTR WOUND 2023:15347346231153531. [PMID: 36734085 DOI: 10.1177/15347346231153531] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Diabetic foot ulcers (DFUs) are common complications of diabetes mellitus that affect patients' quality of life and pose a burden on the healthcare system. Although malnutrition and specific nutritional deficiencies can seriously impact wound healing in patients with chronic nonhealing wounds, the role of nutrition in the prevention and management of DFUs is still not clear. This review discusses the significance of frequent diet assessment and nutritional education of patients with DFUs with individualized correction of deficiencies and emphasis on adequate protein intake along with correction of vitamins D, C, E, and selenium status. Future research should clarify the impact of nutritional interventions, potentially involving the use of probiotics, zinc, and omega-3 fatty acids, and successfully translating the findings into practical guidelines for use in everyday clinical practice.
Collapse
Affiliation(s)
- Kyriaki Apergi
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Nikolaos Papanas
- Diabetes Centre-Diabetic Foot Clinic, Democritus University of Thrace, Alexandroupolis, Greece
| |
Collapse
|
6
|
Karakousis ND, Pyrgioti EE, Georgakopoulos PN, Papanas N. Vitamin B 12 and Diabetic Foot: Α Mini-Review. INT J LOW EXTR WOUND 2022:15347346221143018. [PMID: 36448193 DOI: 10.1177/15347346221143018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
This narrative mini-review article aimed to investigate the potential association of vitamin B12 levels with diabetic neuropathy (DN) and diabetic foot ulcers (DFUs). It was demonstrated that B12 deficiency seems to be related to DFUs in cases of metformin administration and bariatric surgery. B12 supplementation with dietary measures and agents may improve DN and quality of life (QoL). However, data are still preliminary and more experience is needed.
Collapse
Affiliation(s)
| | | | | | - Nikolaos Papanas
- Second Department of Internal Medicine, Diabetes Centre-Diabetic Foot Clinic, Democritus University of Thrace, Alexandroupolis, Greece
| |
Collapse
|
7
|
Badedi M, Muhajir A, Alnami A, Darraj H, Alamoudi A, Agdi Y, Mujayri A, Ageeb A. The severity and clinical characteristics of COVID-19 among patients with type 2 diabetes mellitus in Jazan, Saudi Arabia. Medicine (Baltimore) 2022; 101:e29215. [PMID: 35550472 PMCID: PMC9276086 DOI: 10.1097/md.0000000000029215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/14/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The objectives of the current study were to assess the severity and clinical characteristics of coronavirus disease 2019 (COVID-19) among Saudi adults with type 2 diabetes mellitus (T2DM) in Jazan region, Saudi Arabia. METHODS This retrospective cohort study included 412 patients with COVID-19 selected randomly from the Health Electronic Surveillance Network system, which contains the primary data on COVID-19 infections in Jazan. RESULTS COVID-19 disease duration was significantly longer in patients with T2DM (mean = 10.7 days) compared with those without T2DM (mean = 8.3 days) (P = .01). Six (7%) patients experienced an increase in blood glucose concentrations and had to escalate their total daily insulin dose accordingly. Median fasting and random blood glucose levels increased after infection with COVID-19 (pre-COVID median = 119 and 172 mg/dL, respectively; post-COVID median = 148 and 216 mg/dL, respectively) (P = .02). The total insulin dose pre-COVID (median = 42 units/d) increased after infection with COVID-19 (median = 58 units/d) (P = .01). Most patients with T2DM had clinical COVID-19 symptoms (91%) and the remainder (9%) were asymptomatic. A large proportion (80%) of T2DM patients with mild COVID-19 symptoms self-isolated at home. COVID-19 patients with T2DM (11%) who had an oxygen saturation of ≤ 90% and admitted to the intensive care unit were higher than those without T2DM (5%) (P = < .001). COVID-19 patients with T2DM (9%) had higher mortality rate than COVID-19 patients without T2DM (1%) (P = < .001). CONCLUSION COVID-19 patients with T2DM were associated with a higher risk of admission to the intensive care unit and mortality than COVID-19 patients without T2DM.
Collapse
Affiliation(s)
| | | | - Awaji Alnami
- General Directorate of Health Affairs, Jazan, Saudi Arabia
| | - Hussain Darraj
- General Directorate of Health Affairs, Jazan, Saudi Arabia
| | - Aymn Alamoudi
- Faculty of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia
| | - Yasir Agdi
- General Directorate of Health Affairs, Jazan, Saudi Arabia
| | - Ahoud Mujayri
- General Directorate of Health Affairs, Jazan, Saudi Arabia
| | - Atif Ageeb
- General Directorate of Health Affairs, Jazan, Saudi Arabia
| |
Collapse
|
8
|
Farghaly S, Badedi M, Ibrahim R, Sadhan MH, Alamoudi A, Alnami A, Muhajir A. Clinical characteristics and outcomes of post-COVID-19 pulmonary fibrosis: A case-control study. Medicine (Baltimore) 2022; 101:e28639. [PMID: 35060549 PMCID: PMC8772621 DOI: 10.1097/md.0000000000028639] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 12/27/2021] [Indexed: 01/05/2023] Open
Abstract
The development of pulmonary fibrosis is a rare complication of the novel coronavirus disease 2019 (COVID-19). Limited information is available in the literature about that, and the present study aimed to address this gap.This case-control study included 64 patients with post-COVID-19 pulmonary fibrosis who were hospitalized for COVID-19.The percentage of patients aged ≥65 years (44%) who demised was higher than those who survived (25%). Male patients (62%) had higher mortality than female patients (37%). The most frequently reported clinical symptoms were shortness of breath (98%), cough (91%), and fever (70%). Most COVID-19 patients with pulmonary fibrosis (81%) were admitted to an intensive care unit (ICU), and 63% required mechanical ventilation. Bilateral lung infiltrates (94%), "ground glass" opacity (91%), "honeycomb" lung (25%), and pulmonary consolidation (9%) were commonly identified in COVID-19 patients with pulmonary fibrosis who survived. The findings for computed tomography and dyspnea scale were significantly higher in severe cases admitted to the ICU who required mechanical ventilation. A higher computerized tomography score also correlated significantly with a longer duration of stay in hospital and a higher degree of dyspnea. Half of the COVID-19 patients with pulmonary fibrosis (50%) who survived required oxygen therapy, and those with "honeycomb" lung required long-term oxygen therapy to a far greater extent than others. Cox regression revealed that smoking and asthma were significantly associated with ICU admission and the risk of mortality.Post-COVID-19 pulmonary fibrosis is a severe complication that leads to permanent lung damage or death.
Collapse
Affiliation(s)
- Shereen Farghaly
- Pulmonology Department, King Fahad Central Hospital, Jazan Health Affairs, Saudi Arabia
| | - Mohammed Badedi
- Administration of Research & Studies, Jazan Health Affairs, Saudi Arabia
| | - Rehab Ibrahim
- Pulmonology Department, King Fahad Central Hospital, Jazan Health Affairs, Saudi Arabia
| | - Murad H. Sadhan
- Radiology Department, King Fahad Central Hospital, Jazan Health Affairs, Saudi Arabia
| | - Aymn Alamoudi
- Faculty of Public Health and Tropical Medicine, Jazan University, Saudi Arabia
| | - Awaji Alnami
- Administration of Research & Studies, Jazan Health Affairs, Saudi Arabia
| | | |
Collapse
|
9
|
Uckun FM, Orhan C, Tuzcu M, Durmus AS, Ozercan IH, Volk M, Sahin K. RJX Improves Wound Healing in Diabetic Rats. Front Endocrinol (Lausanne) 2022; 13:874291. [PMID: 35721744 PMCID: PMC9201994 DOI: 10.3389/fendo.2022.874291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We recently reported the clinical safety profile of RJX, a well-defined intravenous GMP-grade pharmaceutical formulation of anti-oxidant and anti-inflammatory vitamins as active ingredients, in a Phase 1 study in healthy volunteers (ClinicalTrials.gov Identifier: NCT03680105) (Uckun et al., Front. Pharmacol. 11, 594321. 10.3389/fphar.2020.594321). The primary objective of the present study was to examine the effects of GMP-grade RJX on wound and burn injury healing in diabetic rats. METHODS In the present study, a rat model of T2DM was used that employs HFD in combination with a single injection of STZ intraperitoneally (i.p) at a moderate dose level (45 mg/kg). Anesthetized diabetic rats underwent full-thickness skin excision on the back or were subjected to burn injury via a heated brass probe and then started on treatments with normal saline (NS = vehicle) or RJX administered via intraperitoneal injections for three weeks. FINDINGS Notably, diabetic rats treated with the 1.25 mL/kg or 2.5 mL/kg RJX (DM+RJX groups) rapidly healed their wounds as fast as non-diabetic control rats. Inflammatory cell infiltration in the dermis along with fibrin and cell debris on the epithelial layer persisted for up to 14 days in the DM+NS group but not in RJX-treated groups. The histopathological score of wound healing on days 7 and 14 was better in diabetic rats treated with RJX than diabetic rats treated with NS and comparable to the scores for non-diabetic healthy rats consistent with an accelerated healing process. The residual wound area of RJX-treated rats was significantly smaller than that of NS-treated diabetic rats at each evaluation time point (P<0.001). The accelerating effect of RJX on diabetic wound healing was dose-dependent. We obtained similar results in the burn injury model. Our results demonstrate that RJX - at a dose level >10-fold lower than its clinical maximum tolerated dose (MTD) - accelerates the healing of excision wounds as well burn injury in diabetic rats.
Collapse
Affiliation(s)
- Fatih M. Uckun
- Drug Discovery Program, Reven Pharmaceuticals, Westminster, CO, United States
- Department of Developmental Therapeutics, Immunology, and Integrative Medicine, Ares Pharmaceuticals, St. Paul, MN, United States
- *Correspondence: Fatih M. Uckun, ; orcid.org/0000-0001-9334-183X
| | - Cemal Orhan
- Department of Animal Nutrition, Faculty of Veterinary Medicine, Firat University, Elazig, Turkey
| | - Mehmet Tuzcu
- Department of Biology, Faculty of Science, Firat University, Elazig, Turkey
| | - Ali Said Durmus
- Department of Surgery Faculty of Veterinary Medicine, Firat University, Elazig, Turkey
| | - Ibrahim H. Ozercan
- Department of Pathology Faculty of Medicine, Firat University, Elazig, Turkey
| | - Michael Volk
- Drug Discovery Program, Reven Pharmaceuticals, Westminster, CO, United States
| | - Kazim Sahin
- Department of Animal Nutrition, Faculty of Veterinary Medicine, Firat University, Elazig, Turkey
| |
Collapse
|
10
|
Badedi M, Alnami A, Darraj H, Alrajhi A, Mutawwam DA, Somaily M, Alshareefi A, Muhajir A, Majrabi Y. Clinical characteristics and ABO blood groups in COVID-19 patients, Saudi Arabia. Medicine (Baltimore) 2021; 100:e26738. [PMID: 34397712 PMCID: PMC8322480 DOI: 10.1097/md.0000000000026738] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 06/25/2021] [Indexed: 01/04/2023] Open
Abstract
This study assessed the proportion of ABO blood groups and clinical characteristics among Saudi patients with coronavirus disease 2019 (COVID-19) in Jazan, Saudi Arabia.This retrospective cohort study included 404 Saudi adults with COVID-19, confirmed by the real-time reverse transcription-polymerase chain reaction. The participants were selected randomly between July 1, 2020, and July 31, 2020, from the Health Electronic Surveillance Network system, which contains the primary data on COVID-19 infections in Jazan.Blood type O (62.4%) represented the highest proportion in COVID-19 Saudi patients followed by the other blood groups which distributed as follows: blood type A (25.5%), blood type B (10.1%), and blood type AB (2%). Men, and people aged 18-44 years, represented the higher percentage than women and those of a younger age. The majority of the patients with COVID-19 had clinical symptoms (88.4%), and the remainder (11.6%) were asymptomatic. Ninety four percent of the patients had mild COVID-19 symptoms and self-isolated at home. Only 6.4% of the cases were severe and admitted to hospital. There was no significant association between a specific ABO blood group and COVID-19 clinical symptoms (P = .950), incubation period (P = .780), disease duration (P = .430), and disease severity (P = .340). Old age and diabetes were the significant predictors of COVID-19 severity and hospital admission (P = .010).Blood group O represented the highest proportion of COVID-19 Saudi patients as it is the most common blood group in Saudi individuals in Jazan. However, no specific blood group was associated with COVID-19 severity and hospital admission. Old age and diabetes mellitus were shown to be significant predictors of severe COVID-19 and hospital admission.
Collapse
Affiliation(s)
- Mohammed Badedi
- Administration of Research & Studies, Jazan Health, Saudi Arabia
| | | | | | - Anas Alrajhi
- Adminstration of Infectious Diseases in Jazan Health, Saudi Arabia
| | | | | | | | | | | |
Collapse
|
11
|
Bechara N, Gunton JE, Flood V, Hng TM, McGloin C. Associations between Nutrients and Foot Ulceration in Diabetes: A Systematic Review. Nutrients 2021; 13:nu13082576. [PMID: 34444735 PMCID: PMC8400510 DOI: 10.3390/nu13082576] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/23/2021] [Accepted: 07/24/2021] [Indexed: 11/16/2022] Open
Abstract
We reviewed the literature to evaluate potential associations between vitamins, nutrients, nutritional status or nutritional interventions and presence or healing of foot ulceration in diabetes. Embase, Medline, PubMed, and the Cochrane Library were searched for studies published prior to September 2020. We assessed eligible studies for the association between nutritional status or interventions and foot ulcers. Fifteen studies met the inclusion criteria and were included in this review. Overall, there is a correlation between poor nutritional status and the presence of foot ulceration or a delay in healing. However, there is not enough data to reach conclusions about whether the relationships are causal or only association. Further research is required to test whether any forms of nutritional supplementation improve foot ulcer healing.
Collapse
Affiliation(s)
- Nada Bechara
- Department of Diabetes and Endocrinology, Blacktown-Mt Druitt Hospital, Blacktown, NSW 2148, Australia; (N.B.); (T.-M.H.); (C.M.)
- Westmead Hospital, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Centre for Diabetes, Obesity and Endocrinology Research (CDOER), The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW 2145, Australia
| | - Jenny E. Gunton
- Westmead Hospital, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Centre for Diabetes, Obesity and Endocrinology Research (CDOER), The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW 2145, Australia
- Garvan Institute of Medical Research, Darlinghurst, NSW 2010, Australia
- Correspondence:
| | - Victoria Flood
- Westmead Hospital, Research and Education Network, Western Sydney Local Health District, Westmead, NSW 2145, Australia;
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Tien-Ming Hng
- Department of Diabetes and Endocrinology, Blacktown-Mt Druitt Hospital, Blacktown, NSW 2148, Australia; (N.B.); (T.-M.H.); (C.M.)
| | - Clare McGloin
- Department of Diabetes and Endocrinology, Blacktown-Mt Druitt Hospital, Blacktown, NSW 2148, Australia; (N.B.); (T.-M.H.); (C.M.)
| |
Collapse
|
12
|
Badedi M, Darraj H, Alnami AQ, Makrami A, Mahfouz MS, Alhazmi K, Mahmoud N, Mosa H. Epidemiological and Clinical Characteristics of Deceased COVID-19 Patients. Int J Gen Med 2021; 14:3809-3819. [PMID: 34335047 PMCID: PMC8317935 DOI: 10.2147/ijgm.s320713] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/05/2021] [Indexed: 12/19/2022] Open
Abstract
Objective Fatalities due to coronavirus disease 2019 (COVID-19) continue to increase, and information on the epidemiological and clinical characteristics of deceased patients who were hospitalized with COVID-19 is limited in the Arab region. The current study aimed to address this gap. Methods Three hundred and four Saudi patients in Jazan Region, Saudi Arabia, who died after being hospitalized with COVID-19 between July 1, 2020, and December 31, 2020, were analyzed in this retrospective cohort study. Results A greater proportion of male patients (59%), compared to female patients (41%), died due to COVID-19. Just over half (55%) of the deaths due to COVID-19 affected patients aged ≥65 years. More than two-thirds of the deceased COVID-19 patients had diabetes (70%) and hypertension (69%); other comorbidities were obesity (30%), heart disease (30%), and chronic kidney disease (14%). Dyspnea (91%), cough (80%), and fever (70%) were the most frequently reported clinical symptoms. Eighty-five per cent of COVID-19 deaths occurred in patients admitted to the intensive care unit (ICU), and 90% of the patients required mechanical ventilation. Typically, lymphopenia, and neutrophilia were observed on admission and 24 hours prior to death. Creatinine and serum ferritin levels and erythrocyte sedimentation rate and D-dimer plasma levels increased significantly following infection with COVID-19. Lung infiltrates and pulmonary opacity (83%) were the most common findings on chest X-ray. Respiratory failure (70%) and acute respiratory distress syndrome (52%) were the leading complications to death. Logistic and Cox regression revealed that a higher age, smoking, high creatinine and aspartate transaminase levels, and respiratory failure were significantly associated with the risk of mortality during the early stay in hospitals. Conclusion The proportion of comorbidities was high in deceased patients who were hospitalized with COVID-19 in Jazan region, Saudi Arabia. A higher age, smoking, and respiratory failure were significant predictors of mortality during the early stay in hospitals.
Collapse
Affiliation(s)
- Mohammed Badedi
- General Directorate of Health Affairs, Jazan, Jazan Region, Saudi Arabia
| | - Hussain Darraj
- General Directorate of Health Affairs, Jazan, Jazan Region, Saudi Arabia
| | - Awaji Qasem Alnami
- General Directorate of Health Affairs, Jazan, Jazan Region, Saudi Arabia
| | - Ali Makrami
- General Directorate of Health Affairs, Jazan, Jazan Region, Saudi Arabia
| | | | | | - Nahid Mahmoud
- General Directorate of Health Affairs, Jazan, Jazan Region, Saudi Arabia
| | - Halimh Mosa
- General Directorate of Health Affairs, Jazan, Jazan Region, Saudi Arabia
| |
Collapse
|
13
|
Badedi M, Makrami A, Alnami A. Co-morbidity and blood group type risk in coronavirus disease 2019 patients: A case-control study. J Infect Public Health 2021; 14:550-554. [PMID: 33756193 PMCID: PMC7833201 DOI: 10.1016/j.jiph.2020.12.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/23/2020] [Accepted: 12/29/2020] [Indexed: 12/21/2022] Open
Abstract
Objective The objective of the study was to assess mortality risk associated with co-morbidities and blood group type in coronavirus disease 2019 (COVID-19) patients in Jazan, Saudi Arabia. Methods This case–control study enrolled 323 Saudi adults with COVID-19, confirmed by real-time reverse transcription–polymerase chain reaction. The participants were selected randomly between August 31, 2020, and July 1, 2020, from the Health Electronic Surveillance Network system, which contains the primary data on COVID-19 infections in Jazan, Saudi Arabia. The sample included 108 patients who died due to COVID-19 disease and 215 controls who recovered from it (1:2 ratio). The chi-square test, independent samples t-test, and logistic regression were used to perform the statistical analysis. Results Mortality was higher in older age patients with COVID-19 (mean = 65.4 years, standard deviation [SD] = 15.6) compared to recovered patients (mean = 39.5 years, SD = 14.8) (p < 0.001) with a moderate effect size (eta squared = 0.06). Diabetes mellitus (odds ratio [OR] = 9.4), hypertension (OR = 8.6), cardiovascular disease (OR = 7.4), chronic kidney disease (OR = 3.3), and obesity (OR = 2.0) were significantly associated with death due to COVID-19. Using logistic regression analysis, older age and diabetes mellitus were the primary independent predictors of COVID-19 mortality. However, there was no significant association between a specific ABO blood group and mortality risk (P = 0.07). Conclusion Older age and the presence of co-morbidities, especially diabetes mellitus, increased the risk of death in patients with COVID-19. Establishing the causality of death in patients with COVID-19 should be a key aim of future studies.
Collapse
Affiliation(s)
- Mohammed Badedi
- Administration of Research & Studies, Jazan Health, Saudi Arabia.
| | | | | |
Collapse
|
14
|
Alzughbi T, Badedi M, Darraj H, Hummadi A, Jaddoh S, Solan Y, Sabai A. Diabetes-Related Distress and Depression in Saudis with Type 2 Diabetes. Psychol Res Behav Manag 2020; 13:453-458. [PMID: 32547267 PMCID: PMC7239888 DOI: 10.2147/prbm.s255631] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 05/08/2020] [Indexed: 12/14/2022] Open
Abstract
Objective This study aims to assess the prevalence of diabetes mellitus (DM)-related distress and depression and their associated factors in Saudi people with type 2 DM (T2DM) in Jazan, Saudi Arabia. It also aims to assess the association between glycemic control and DM-related distress and depression. Methods This is an analytical, cross-sectional study which recruited 300 Saudi patients with T2DM randomly from primary healthcare centers in Jazan, Saudi Arabia. DM-related distress and depression were measured by valid questionnaires, the 17-item Diabetes Distress Scale and the Patient Health Questionnaire-9, respectively. Logistic regression and an independent t-test were performed in the statistical analysis. Results The mean age of the study population was 52.7 years, with a range of 23–83 years. The number of males was 147 (49%) and females was 153 (51%) in the study population. The prevalence of DM-related distress and depression in Saudi patients with T2DM in Jazan was 22.3% and 20%, respectively, and about 7.7% had both. Of DM-related distress, 12.3% had interpersonal-related DM distress, 11.7% had physician-related DM distress, 10.7% had emotional-related DM distress, and 7% had regimen-related DM distress. After adjusting for covariates, being female, patients aged <45, physical inactivity, DM duration <5 years, and smoking were significantly associated with DM-related distress and depression. There was also a significant association between DM-related distress and depression, OR = 3 [95% CI: 1.8, 6.4]. Furthermore, we found that glycated hemoglobin (A1C) levels were significantly higher in those with DM-related distress (small effect size, eta squared = 0.04) and depression (moderate effect size, eta squared = 0.06) (P < 0.001). Conclusion DM-related distress and depression are prevalent in patients with T2DM in Jazan, Saudi Arabia. Both these conditions need to be screened for and addressed in clinical settings. Establishing the causality of DM-related distress and depression in T2DM is an important aim for any future studies.
Collapse
Affiliation(s)
- Turki Alzughbi
- Jazan Diabetes and Endocrine Center, Jazan Health Affairs, Jazan, Saudi Arabia
| | - Mohammed Badedi
- Jazan Diabetes and Endocrine Center, Jazan Health Affairs, Jazan, Saudi Arabia
| | - Hussain Darraj
- Jazan Diabetes and Endocrine Center, Jazan Health Affairs, Jazan, Saudi Arabia
| | - Abdulrahman Hummadi
- Jazan Diabetes and Endocrine Center, Jazan Health Affairs, Jazan, Saudi Arabia
| | - Sattam Jaddoh
- Jazan Psychiatry Hospital, Jazan Health Affairs, Jazan, Saudi Arabia
| | - Yahiya Solan
- Jazan Diabetes and Endocrine Center, Jazan Health Affairs, Jazan, Saudi Arabia
| | - Abdullah Sabai
- Public Health Administration, Jazan Health Affairs, Jazan, Saudi Arabia
| |
Collapse
|