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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.
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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
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Chi L, Wang Q, Zhong W, Pan X, Li Y. The usefulness of platelet-rich plasma to manage skin wounds: A meta-analysis. Int Wound J 2023; 20:3123-3130. [PMID: 37128184 PMCID: PMC10502258 DOI: 10.1111/iwj.14188] [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] [Received: 03/17/2023] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 05/03/2023] Open
Abstract
A meta-analysis investigation to measure the usefulness of platelet-rich plasma (PRP) to manage skin wounds (SWs). A comprehensive literature inspection till February 2023 was applied and 1349 interrelated investigations were reviewed. The 22 chosen investigations enclosed animals' SWs were in the chosen investigations' starting point, 3348 of them were treated with PRP, and 2259 were control. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were used to compute the value of the usefulness of PRP to manage SWs by the dichotomous and continuous approaches and a fixed or random model. PRP significantly higher percent of decreases in open wound area (OWA) (MD, 10.07; 95% CI, 6.55-13.59, P < 0.001), and lower healing time (HT) (MD, -6.31; 95% CI, -10.69 to -1.93, P = 0.005) compared to control in animals' SWs. PRP had a significantly higher percent of decreases in OWA and lower HT compared to control in animals' SWs. However, caused of the small sample sizes of several chosen investigations for this meta-analysis, care must be exercised when dealing with its values.
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Affiliation(s)
- Liqiao Chi
- Department of Dermatology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Qiang Wang
- Department of Dermatology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Wenjun Zhong
- Department of Dermatology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Xinfeng Pan
- Department of Dermatology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Yuanyuan Li
- Department of Dermatology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
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Li X, Kou S, Chen G, Zhao B, Xue J, Ding R, Zhao X, Ye M, Yang Y, Yue R, Li F. The relationship between vitamin D deficiency and diabetic foot ulcer: A meta-analysis. Int Wound J 2023; 20:3015-3022. [PMID: 37194326 PMCID: PMC10502267 DOI: 10.1111/iwj.14177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 05/18/2023] Open
Abstract
A meta-analysis investigation to measure the relationship between vitamin D deficiency (VDD) and diabetic foot ulcer (DFU). A comprehensive literature inspection till February 2023 was applied and 1765 interrelated investigations were reviewed. The 15 chosen investigations enclosed 2648 individuals with diabetes mellitus in the chosen investigations' starting point, 1413 of them were with DFUs, and 1235 were without DFUs. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were used to compute the value of the relationship between VDD and DFU by the dichotomous and continuous approaches and a fixed or random model. Individuals with DFUs had significantly lower vitamin D levels (VDL) (MD, -7.14; 95% CI, -8.83 to -5.44, P < 0.001) compared to those without DFU individuals. Individuals with DFUs had a significantly higher number of VDD individuals (OR, 2.27; 95% CI, 1.63-3.16, P < 0.001) compared to those without DFU individuals. Individuals with DFU had significantly lower VDL and a significantly higher number of VDD individuals compared to those without DFU individuals. However, caused of the small sample sizes of several chosen investigations for this meta-analysis, care must be exercised when dealing with its values.
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Affiliation(s)
- Xin Li
- Department of EndocrinologyHospital of Chengdu University of Traditional Chinese MedicineChengduChina
| | - Shaojie Kou
- Department of Liver DiseaseShaanxi Provincial Hospital of Traditional Chinese MedicineXi'anChina
| | - Guo Chen
- Department of Infectious DiseasesHospital of Chengdu University of Traditional Chinese MedicineChengduChina
| | - Bingjie Zhao
- Department of HaematologyHospital of Chengdu University of Traditional Chinese MedicineChengduChina
| | - Jingdong Xue
- Department of Liver DiseaseShaanxi Provincial Hospital of Traditional Chinese MedicineXi'anChina
| | - Rui Ding
- Department of EndocrinologyHospital of Chengdu University of Traditional Chinese MedicineChengduChina
| | - Xiaoyan Zhao
- Department of EndocrinologyHospital of Chengdu University of Traditional Chinese MedicineChengduChina
| | - Miaoqing Ye
- Department of Liver DiseaseShaanxi Provincial Hospital of Traditional Chinese MedicineXi'anChina
| | - Yueqing Yang
- Department of Liver DiseaseShaanxi Provincial Hospital of Traditional Chinese MedicineXi'anChina
| | - Rensong Yue
- Department of EndocrinologyHospital of Chengdu University of Traditional Chinese MedicineChengduChina
| | - Fenping Li
- Department of Liver DiseaseShaanxi Provincial Hospital of Traditional Chinese MedicineXi'anChina
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Zhen R, Ban J, Jia Z, Liu Y, Li Z, Chen S. The Relationship Between Non-HDL-C /HDL-C Ratio (NHHR) and Vitamin D in Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes 2023; 16:2661-2673. [PMID: 37670851 PMCID: PMC10476667 DOI: 10.2147/dmso.s414673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/19/2023] [Indexed: 09/07/2023] Open
Abstract
Purpose The objective of this research was to examine the relationship between non-HDL cholesterol/HDL cholesterol ratio (NHHR) and vitamin D in type 2 diabetes mellitus (T2DM). Patients and Methods This study enrolled 617 T2DM participants. Participants were separated into two groups: no vitamin D deficiency and vitamin D deficiency. Participants were split into two categories: individuals who had a high NHHR and those with a low NHHR, with the median NHHR serving as the cut-off. Eventually, the study participants were classified into two groups by gender, which were further classified into vitamin D deficient and non-vitamin D deficient groups. Results NHHR values were substantially greater in vitamin D deficient group than in the non-deficient group in both male and female T2DM patients (P<0.05). The high NHHR group displayed substantially lower vitamin D levels than the low NHHR group [16.21 (12.55,21.35) vs 19.05 (14.59,24.07), P<0.001]. NHHR was discovered to be negatively and independently associated with vitamin D levels, and there was no sex difference. Conclusion For the first time, our research revealed a negative relationship between NHHR and vitamin D in patients with T2DM.
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Affiliation(s)
- Ruoxi Zhen
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Jiangli Ban
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
- Graduate School, Hebei North University, Zhangjiakou, People’s Republic of China
| | - Zhuoya Jia
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Yanhui Liu
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
- Graduate School, Hebei North University, Zhangjiakou, People’s Republic of China
| | - Zelin Li
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Shuchun Chen
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
- Hebei Key Laboratory of Metabolic Diseases, Shijiazhuang, Hebei, People’s Republic of China
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Mirghani HO. Vitamin D deficiency among outpatients and hospitalized patients with diabetic foot ulcers: A systematic review and meta-analysis. World J Meta-Anal 2023; 11:218-227. [DOI: 10.13105/wjma.v11.i5.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 03/06/2023] [Accepted: 05/06/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The definition of diabetic foot syndrome (DFS) varies depending on the location and resources. Few classifications are available according to the indication. DF ulcers and vitamin D deficiency are common diseases among patients with diabetes. Previous literature has shown an association between DF ulcer (DFU) and vitamin D deficiency. However, the available meta-0analysis was limited by substantial bias.
AIM To investigate the association between DFUs and vitamin D levels.
METHODS We searched PubMed, MEDLINE, and Cochrane Library, EBSCO, and Google Scholar for studies comparing vitamin D levels and DF. The keywords DFU, DFS, diabetic septic foot, vitamin D level, 25-hydroxy vitamin D, vitamin D status, and vitamin D deficiency were used. The search engine was set for articles published during the period from inception to October 2022. A predetermined table was used to collect the study information.
RESULTS Vitamin D level was lower among patients with DFU compared to their counterparts [odds ratio (OR): -5.77; 95% confidence interval (CI): -7.87 to -3.66; χ2 was 84.62, mean difference, 9; I2 for heterogeneity, 89%; P < 0.001 and P for overall effect < 0.001]. The results remained robust for hospitalized patients (OR: -6.32 95%CI: -11.66 to -0.97; χ2 was 19.39; mean difference, 2; I2 for heterogeneity, 90%; P = 0.02).
CONCLUSION Vitamin D was lower among outpatients and hospitalized patients with DFUs. Further larger randomized controlled trials are needed.
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Affiliation(s)
- Hyder Osman Mirghani
- Department of Internal Medicine, Faculty of Medicine, University of Tabuk, Saudi Arabia, Tabuk 3378, Saudi Arabia
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Md Isa Z, Amsah N, Ahmad N. The Impact of Vitamin D Deficiency and Insufficiency on the Outcome of Type 2 Diabetes Mellitus Patients: A Systematic Review. Nutrients 2023; 15:2310. [PMID: 37242192 PMCID: PMC10223393 DOI: 10.3390/nu15102310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
Vitamin D deficiency and insufficiency are public health concerns that have contributed to multiple negative health outcomes. Recent studies have revealed that vitamin D deficiency and insufficiency influence glycaemic control and the development of diabetes complications. The goal of this systematic review is to summarise the latest evidence on the impact of vitamin D deficiency and insufficiency on the outcome of Type 2 Diabetes Mellitus (T2DM) patients. In this PRISMA-guided systematic review, articles were sourced from three databases, namely, PubMed, Scopus, and Web of Science. The review only included literature published from 2012 until 2022, and 33 eligible studies met the inclusion criteria for this review. The included articles were critically appraised using the Mixed Method Appraisal Tool (MMAT). According to our findings, vitamin D deficiency or insufficiency is associated with mental health status, macrovascular and microvascular complications of T2DM, metabolic syndrome, increased risk of obesity, increased blood pressure, dyslipidaemia, glycaemic control, nerve-related disease, musculoskeletal-related complications, and reduced quality of life. Due to the diverse implications of vitamin D deficiency and insufficiency, screening for vitamin D levels in T2DM patients may be beneficial.
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Affiliation(s)
| | | | - Norfazilah Ahmad
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia; (Z.M.I.); (N.A.)
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Tang Y, Huang Y, Luo L, Xu M, Deng D, Fang Z, Zhao X, Chen M. Level of 25-hydroxyvitamin D and vitamin D receptor in diabetic foot ulcer and factor associated with diabetic foot ulcers. Diabetol Metab Syndr 2023; 15:30. [PMID: 36829206 PMCID: PMC9951493 DOI: 10.1186/s13098-023-01002-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/17/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND At present, there is no clinical study to elucidate the correlation between vitamin D deficiency and the incidence of diabetic foot osteomyelitis (DFO).This study aims to clarify levels of 25-hydroxyvitamin D [25(OH)VD] in peripheral blood and vitamin D receptor (VDR) expression in wound margin tissues (T-VDR) of patients with type 2 diabetes mellitus (T2DM) with diabetic foot ulcer (DFU) and DFO, and to determine its correlation with treatment outcomes of DFU and DFO, and and its value as a potential biomarker for the diagnosis of DFU and DFO. METHODS 156 T2DM patients with DFU (DFU group), 100 T2DM patients without DFU (T2DM group), and 100 healthy controls (NC group). The DFU group patients were subdivided into DFO (n = 80) and NDFO groups (n = 76). The level of serum 25(OH)VD was measured via chemiluminescence immunoassay, and T-VDR expression level was determined by quantitative real-time PCR. RESULTS The levels of serum 25(OH)VD in the DFU group were significantly lower than the T2DM group [(10.3 (5.8, 18.7) vs 15.7 (8.6, 24.6) ng/mL, P = 0.002)]. Similarly, the levels of serum 25(OH)VD and T-VDR expression in the DFO group were statistically lower than the NDFO group [9.2 (5.2, 20.5) vs 12.8 (6.9, 22.1) ng/mL, P = 0.006)], [1.96 (0.61, 3.97) vs 3.11 (1.36, 5.11), P = 0.004)], respectively. Furthermore, the levels of serum 25(OH)VD and T-VDR expression in DFU patients were positively correlated with the ulcer healing rate of foot ulcer after 8 weeks of treatment ( P = 0.031, P = 0.016, respectively). Multivariate logistic regression analysis showed that low level of serum 25(OH)VD was an independent risk factor for DFU and DFO (ORDFU = 2.42, ORDFO = 3.05, P = 0.008, 0.001, respectively), and decreased T-VDR expression level was an independent risk factor for DFO (OR = 2.83, P = 0.004). Meanwhile, the ROC curve analysis indicated that the AUC of serum 25(OH)VD level for the diagnosis of DFU and DFO was 0.821 (95% CI, 0.754-0.886, P < 0.001) and 0.786 (95%CI, 0.643-0.867, P < 0.001), respectively. When establishing a diagnosis of DFO, the AUC of T-VDR expression level was 0.703 (95%CI: 0.618-0.853, P < 0.001). CONCLUSIONS The levels of serum 25(OH)VD and T-VDR expression in DFU and DFO decreased. Serum 25(OH)VD and T-VDR are potentially valuable biomarkers for diagnosis and prognosis of DFU and DFO. .
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Affiliation(s)
- Ying Tang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui People’s Republic of China
| | - Yixuan Huang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui People’s Republic of China
| | - Li Luo
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui People’s Republic of China
| | - Murong Xu
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui People’s Republic of China
| | - Datong Deng
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui People’s Republic of China
| | - Zhaohui Fang
- Department of Endocrinology, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, Anhui People’s Republic of China
| | - Xiaotong Zhao
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui People’s Republic of China
| | - Mingwei Chen
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui People’s Republic of China
- Department of Endocrinology, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, Anhui People’s Republic of China
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Dai J, Zhou Y, Mei S, Chen H. Application of antibiotic bone cement in the treatment of infected diabetic foot ulcers in type 2 diabetes. BMC Musculoskelet Disord 2023; 24:135. [PMID: 36810078 PMCID: PMC9942328 DOI: 10.1186/s12891-023-06244-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 02/15/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND In this study, we try to investigate the effect of antibiotic bone cement in patients with infected diabetic foot ulcer (DFU). METHODS This is a retrospective study, including fifty-two patients with infected DFU who had undergone treated between June 2019 and May 2021. Patients were divided into Polymethylmethacrylate (PMMA) group and control group. 22 patients in PMMA group received antibiotic bone cement and regular wound debridement, and 30 patients in control group received regular wound debridement. Clinical outcomes include the rate of wound healing, duration of healing, duration of wound preparation, rate of amputation, and frequency of debridement procedures. RESULTS In PMMA group, twenty-two patients (100%) had complete wound healing. In control group, twenty-eight patients (93.3%) had wound healing. Compared with control group, PMMA group had fewer frequencies of debridement procedures and shorter duration of wound healing (35.32 ± 3.77 days vs 44.37 ± 7.44 days, P < 0.001). PMMA group had five minor amputation, while control group had eight minor amputation and two major amputation. Regarding the rate of limb salvage, there was no limb lose in PMMA group and two limb losses in control group. CONCLUSION The application of antibiotic bone cement is an effective solution for infected DFU treatment. It can effectively decreased the frequency of debridement procedures and shorten the healing duration in patients with infected DFU.
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Affiliation(s)
- Jiezhi Dai
- grid.412528.80000 0004 1798 5117Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Yu Zhou
- Department of Orthopedic Surgery, Civil Aviation Hospital of Shanghai, Shanghai, China
| | - Shasha Mei
- Department of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
| | - Hua Chen
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
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Farahmand MA, Daneshzad E, Fung TT, Zahidi F, Muhammadi M, Bellissimo N, Azadbakht L. What is the impact of vitamin D supplementation on glycemic control in people with type-2 diabetes: a systematic review and meta-analysis of randomized controlled trails. BMC Endocr Disord 2023; 23:15. [PMID: 36647067 PMCID: PMC9841647 DOI: 10.1186/s12902-022-01209-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 11/10/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND There is conflicting evidence on the effect of vitamin D on glycemic control. Therefore, in the current meta-analyses, we aimed to assess the effect of vitamin D supplementation on the glycemic control of type 2 diabetes (T2D) patients. METHODS We conducted a comprehensive search in electronic databases including; PubMed/Medline, Web of Science, Scopus, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and NIH's Clinical Trials Registry, from the inception of each database up to January first, 2021. RESULTS A total of 46 randomized controlled trials (RCTs) consisting of 2164 intervention subjects and 2149 placebo controls were included in this meta-analysis. Pooled analyses for HbA1c showed a significant change between the intervention and placebo group, the weighted mean difference (WMD)(95% confidence interval(CI)) was -0.20%(-0.29, -0.11) with P < 0.001. Analyses for assessing changes in FPG found a significant reduction in the intervention group after vitamin D supplementation, the WMD (95%CI) was -5.02 mg/dl (-6.75,-3.28) with P < 0.001. The result of pooled analyses for HOMA-IR revealed a significant change between the intervention and control group, the WMD (95%CI) was -0.42(-0.76, -0.07) with P = 0.019. The subgroup analyses showed the most efficacy in a higher dose and short intervention period and in subjects with deficient vitamin D status. CONCLUSION Vitamin D supplementation might be beneficial for the reduction of FPG, HbA1c, and HOMA-IR in type 2 diabetes patients with deficient vitamin D status. This effect was especially prominent when vitamin D was given in large doses and for a short period of time albeit with substantial heterogeneity between studies and a probability of publication bias.
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Affiliation(s)
- Mohammad Ashraf Farahmand
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), PO BOX: 1416643931, Tehran, Iran
- Public Health Faculty, Kabul University of Medical Science (KUMS), Kabul, Afghanistan
| | - Elnaz Daneshzad
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Teresa T Fung
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
- Department of Nutrition, Simmons University, Boston, MA, USA
| | - Fawzia Zahidi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), PO BOX: 1416643931, Tehran, Iran
| | - Maryam Muhammadi
- Critical Nursing Care Department, Kabul University of Medical Science (KUMS), Kabul, Afghanistan
| | - Nick Bellissimo
- School of Nutrition, Toronto Metropolitan University, Toronto, ON, Canada
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), PO BOX: 1416643931, Tehran, Iran.
- Diabetes Research Centre, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Lin J, Mo X, Yang Y, Tang C, Chen J. Association between vitamin D deficiency and diabetic foot ulcer wound in diabetic subjects: A meta-analysis. Int Wound J 2023; 20:55-62. [PMID: 35567425 PMCID: PMC9797924 DOI: 10.1111/iwj.13836] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 04/21/2022] [Accepted: 04/24/2022] [Indexed: 01/07/2023] Open
Abstract
A meta-analysis was performed to evaluate the association between vitamin D deficiency and diabetic foot ulcer wounds in diabetic subjects. A systematic literature search up to March 2022 incorporated 7586 subjects with diabetes mellitus at the beginning of the study; 1565 were using diabetic subjects with foot ulcer wounds, and 6021 were non-ulcerated diabetic subjects. Statistical tools like the dichotomous and contentious method were used within a random or fixed-influence model to establish the odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) to evaluate the influence of vitamin D deficiency in managing diabetic foot ulcer wound. Diabetic subjects with foot ulcer wounds had significantly lower vitamin D levels (MD, -6.48; 95% CI, -10.84 to -2.11, P < .004), higher prevalence of vitamin D deficiency (<50 nmoL/L) (OR, 1.82; 95% CI, 1.32-2.52, P < .001), and higher prevalence of severe vitamin D deficiency (OR, 2.53; 95% CI, 1.65-3.89, P < .001) compared with non-ulcerated diabetic subjects. Diabetic subjects with foot ulcer wounds had significantly lower vitamin D levels, higher prevalence of vitamin D deficiency, and higher prevalence of severe vitamin D deficiency compared with non-ulcerated diabetic subjects. Further studies are required to validate these findings.
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Affiliation(s)
- Juan Lin
- Nursing School of Shaoyang UniversityHunanChina
| | - Xinxin Mo
- Nursing School of Shaoyang UniversityHunanChina
| | - Yejun Yang
- Department of PediatricShaoyang Central HospitalHunanChina
| | - Chao Tang
- Nursing School of Shaoyang UniversityHunanChina
| | - Jia Chen
- Xiangya School of Nursing School of Central South UniversityHunanChina
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Kurian SJ, Baral T, Unnikrishnan MK, Benson R, Munisamy M, Saravu K, Rodrigues GS, Rao M, Kumar A, Miraj SS. The association between micronutrient levels and diabetic foot ulcer: A systematic review with meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1152854. [PMID: 37065742 PMCID: PMC10090454 DOI: 10.3389/fendo.2023.1152854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Diabetic foot ulcers (DFU) are a major complication of diabetes mellitus (DM). Nutrient deficiencies are among the major risk factors in DFU development and healing. In this context, we aimed to investigate the possible association between micronutrient status and risk of DFU. METHODS A systematic review (Prospero registration: CRD42021259817) of articles, published in PubMed, Web of Science, Scopus, CINAHL Complete, and Embase, that measured the status of micronutrients in DFU patients was performed. RESULTS Thirty-seven studies were considered, of which thirty were included for meta-analysis. These studies reported levels of 11 micronutrients: vitamins B9, B12, C, D, E, calcium, magnesium, iron, selenium, copper, and zinc. DFU, compared to healthy controls (HC) had significantly lower vitamin D (MD: -10.82 14 ng/ml, 95% CI: -20.47, -1.16), magnesium (MD: -0.45 mg/dL, 95% CI: -0.78, -0.12) and selenium (MD: -0.33 µmol/L, 95% CI: -0.34, -0.32) levels. DFU, compared to DM patients without DFU, had significantly lower vitamin D (MD: -5.41 ng/ml, 95% CI: -8.06, -2.76), and magnesium (MD: -0.20 mg/dL, 95% CI: -0.25, -0.15) levels. The overall analysis showed lower levels of vitamin D [15.55ng/ml (95% CI:13.44, 17.65)], vitamin C [4.99µmol/L (95% CI:3.16, 6.83)], magnesium [1.53mg/dL (95% CI:1.28, 1.78)] and selenium [0.54µmol/L (95% CI:0.45, 0.64)]. CONCLUSION This review provides evidence that micronutrient levels significantly differ in DFU patients, suggesting an association between micronutrient status and risk of DFU. Therefore, routine monitoring and supplementations are warranted in DFU patients. We suggest that personalized nutrition therapy may be considered in the DFU management guidelines. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=259817, identifier CRD42021259817.
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Affiliation(s)
- Shilia Jacob Kurian
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of High Education, Manipal, Karnataka, India
- Manipal Centre for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Tejaswini Baral
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of High Education, Manipal, Karnataka, India
- Manipal Centre for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | - Ruby Benson
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of High Education, Manipal, Karnataka, India
| | - Murali Munisamy
- Department of Translational Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Kavitha Saravu
- Manipal Centre for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Department of Infectious Diseases, Kasturba Medical College and Hospital, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | - Mahadev Rao
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of High Education, Manipal, Karnataka, India
| | - Amit Kumar
- Department of Laboratory Medicine, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Sonal Sekhar Miraj
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of High Education, Manipal, Karnataka, India
- Manipal Centre for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
- *Correspondence: Sonal Sekhar Miraj,
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Wang F, Zhou L, Zhu D, Yang C. A Retrospective Analysis of the Relationship Between 25-OH-Vitamin D and Diabetic Foot Ulcer. Diabetes Metab Syndr Obes 2022; 15:1347-1355. [PMID: 35535217 PMCID: PMC9078343 DOI: 10.2147/dmso.s358170] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/27/2022] [Indexed: 11/23/2022] Open
Abstract
Background The fat-soluble molecule vitamin D has attracted much attention since its pleiotropism was discovered. Its effectiveness can be attributed to the presence of vitamin D receptors in most of the body's tissues. Based on the classical role of vitamin D in regulating calcium and phosphorus metabolism and maintaining bone health, the role of vitamin D in immunity, type 2 diabetes mellitus (T2DM), tumor and cardiovascular diseases has been further discovered. Some experiments have shown that vitamin D can restore the production of antimicrobial peptides (AMP) in primary diabetic foot ulcer (DFU) cells, which can improve in vitro wound healing, indicating its potential therapeutic use in DFU therapy. In addition, vitamin D can also inhibit the secretion of T-helper type 1 (Th1) cytokines IFN-Y and IL-2 while stimulating the production of Th2 cytokines, thereby promoting wound healing. Objective To investigate the relationship between 25-OH-vitamin D level and DFU in diabetes mellitus (DM) patients, and to provide a theoretical basis for the early prevention and treatment of DFU. Methods The clinical data of 429 hospitalized patients with DM were retrospectively analyzed in this case-control study. The patients were divided into the DFU group (n = 242) and non-DFU group (n = 187). Fasting venous blood was drawn from all subjects to detect serum 25-OH-vitamin D levels and blood biochemical parameters, the difference of parameters between DFU group and non-DFU group were analyzed, and the risk factors of DFU were analyzed by logistic regression. Results The difference between the two groups in age, DM duration, gender, diastolic blood pressure, serum creatinine, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, albumin, white blood cell count, hemoglobin, hematocrit, 25-OH-vitamin D was statistically significant (p < 0.05). Multivariate logistic regression analysis showed that 25-OH-vitamin D is an independent protective factor for DFU [OR 95%, CI 0.984 (0.969, 0.998), p < 0.05]. 25-OH-vitamin D nutrition status distribution was different between non-DFU group and DFU group (P < 0.05). Vitamin D deficiency (< 50 nmol/L) accounted for 86.78% of all DFU patients, which was only 74.33% in non-DFU patients. The 25-OH-vitamin D levels of DFU patients from Wagner Grades 1 to 5 showed a downward trend (p < 0.01). Conclusion In conclusion, our study confirms that 25-OH-vitamin D is closely correlated with DFU and that 25-OH-vitamin D is an independent protective factor for DFU. Therefore, vitamin D screening or supplementation might be beneficial to prevent DFU and improve the prognosis of DM patients.
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Affiliation(s)
- Fenglin Wang
- Hebei North University, Zhangjiakou, Hebei, 075000, People’s Republic of China
- Department of Endocrinology, Air Force Medical Center, Beijing, 100142, People’s Republic of China
| | - Luyao Zhou
- Hebei North University, Zhangjiakou, Hebei, 075000, People’s Republic of China
| | - Di Zhu
- Department of Endocrinology, Air Force Medical Center, Beijing, 100142, People’s Republic of China
| | - Caizhe Yang
- Department of Endocrinology, Air Force Medical Center, Beijing, 100142, People’s Republic of China
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Tang W, Chen L, Ma W, Chen D, Wang C, Gao Y, Ran X. Association Between Vitamin D Status and Diabetic Foot in Patients With Type 2 Diabetes Mellitus. J Diabetes Investig 2022; 13:1213-1221. [PMID: 35191197 PMCID: PMC9248421 DOI: 10.1111/jdi.13776] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 01/30/2022] [Accepted: 02/20/2022] [Indexed: 02/05/2023] Open
Abstract
Aims/Introduction To assess the association between vitamin D and diabetic foot (DF) in patients with type 2 diabetes mellitus (T2DM), in order to summarize clinical evidence in the prevention and treatment of DF. Materials and methods Between January 2012 and December 2019, a total of 1,721 hospitalized patients with type 2 diabetes mellitus were continuously enrolled in West China Hospital, Sichuan University, and divided into DF and non‐DF groups according to whether they had DF, and divided into four subgroups according to the admission season. The 25‐OH‐vitamin D levels were compared between groups and subgroups, and independent risk factors discussed for the occurrence of DF. Results The vitamin D insufficiency and deficiency rate were higher in the DF group (77.51%) than in the non‐DF group (59.2%). The 25‐OH‐vitamin D levels were lower in the DF group (35.80 nmol/L) than in the non‐DF group (45.48 nmol/L) (P < 0.001). Patients with poor glycemic control had lower 25‐OH‐vitamin D levels (P = 0.01). The levels of 25‐OH‐vitamin D were lower in winter and spring. In the same season, the levels of 25‐OH‐vitamin D in patients with DF were still lower (P < 0.001). The 25‐OH‐vitamin D levels of patients with Wagner grades 0 to 5 showed a downward trend (P = 0.114). The 25‐OH‐vitamin D level was independently associated with diabetic foot (P < 0.001, OR = 0.986). Conclusions The low serum vitamin D level was significantly associated with a higher prevalence of DF among Chinese patients with type 2 diabetes mellitus. Although vitamin D levels vary seasonally, patients with DF were always at higher risk of having vitamin D insufficiency and deficiency.
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Affiliation(s)
- Weiwei Tang
- Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Lihong Chen
- Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Wanxia Ma
- Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Dawei Chen
- Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Chun Wang
- Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Yun Gao
- Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Xingwu Ran
- Innovation Center for Wound Repair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
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Dai J, Zhou Y, Mei S, Chen H. Application of the distally based sural neurocutaneous flaps in the management of foot and ankle defects in patients with diabetic foot. Front Endocrinol (Lausanne) 2022; 13:1009714. [PMID: 36213287 PMCID: PMC9537483 DOI: 10.3389/fendo.2022.1009714] [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: 08/02/2022] [Accepted: 09/07/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND We report our experience on the use of a distally based sural flap for soft tissue reconstruction of foot and ankle defects in patients with diabetic foot. METHODS The actual study is a retrospective, open, non-controlled, and clinical study of 25 patients treated with diabetic foot on whom reconstruction with distally based sural neurocutaneous flaps was performed from May 2019 to December 2021. RESULTS The mean age was 64.9 years, and there were 15 male and 10 female patients. The mean follow-up was 9.8 months, which ranged from 6 to 12 months. The size of the flaps ranged from 6 × 5 to 15 × 9 cm2. Twenty-two of the 25 flaps survived intact with sufficient blood supply. Two cases had a small superficial necrosis, which was resolved after a change of daily dressing and was heeled eventually. In one case, partial necrosis was observed that was managed with minor revision and the use of split-thickness skin graft. CONCLUSIONS The distally based sural flap is considered to be useful for reconstruction of foot and ankle defects in patients with diabetic foot.
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Affiliation(s)
- Jiezhi Dai
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Yu Zhou
- Department of Orthopedic Surgery, Civil Aviation Hospital of Shanghai, Shanghai, China
| | - Shasha Mei
- Department of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Hua Chen, ; Shasha Mei,
| | - Hua Chen
- Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Hua Chen, ; Shasha Mei,
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15
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Ulloque-Badaracco JR, Mosquera-Rojas MD, Hernandez-Bustamante EA, Alarcón-Braga EA, Ulloque-Badaracco RR, Al-kassab-Córdova A, Herrera-Añazco P, Benites-Zapata VA, Hernandez AV. Association between Lipid Profile and Apolipoproteins with Risk of Diabetic Foot Ulcer: A Systematic Review and Meta-Analysis. Int J Clin Pract 2022; 2022:5450173. [PMID: 36016824 PMCID: PMC9385316 DOI: 10.1155/2022/5450173] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/21/2022] [Accepted: 07/19/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND AIMS Biomarkers are necessary to stratify the risk of diabetic foot ulcers (DFUs). This systematic review and meta-analysis aimed to evaluate the association between the lipid profile and apolipoproteins with the risk of DFU. METHODS A systematic search was conducted in PubMed, Scopus, Cochrane Library, and Web of Science among adult patients. Cohort and case-control studies were included. Random-effects models were used for meta-analyses, and the effects were expressed as odds ratio (OR) and their 95% confidence intervals (CIs). We evaluated publication bias through Egger's test and funnel plot. RESULTS A total of 12 cohort studies and 26 case-control studies were included, with 17076 patients. We found that the higher values of total cholesterol (TC), low-density lipoprotein (LDL), triglycerides, and lipoprotein(a) (Lp(a)) were associated with a higher risk of developing DFU (OR: 1.47, OR: 1.47, OR: 1.5, OR: 1.85, respectively). Otherwise, the lower values of HDL were associated with a higher risk of developing DFU (OR: 0.49). Publication bias was not found for associations between TC, HDL, LDL, or TG and the risk of DFU. CONCLUSIONS The high values of LDL, TC, TG, and Lp(a) and low values of HDL are associated with a higher risk of developing DFU. Furthermore, we did not find a significant association for VLDL, ApoA1, ApoB, and ApoB/ApoA1 ratio.
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Affiliation(s)
- Juan R. Ulloque-Badaracco
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Melany D. Mosquera-Rojas
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Enrique A Hernandez-Bustamante
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Trujillo, Peru
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Esteban A Alarcón-Braga
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | | | | | - Percy Herrera-Añazco
- Universidad Privada San Juan Bautista, Lima, Peru
- Instituto de Evaluación de Tecnologías en Salud e Investigación—IETSI, EsSalud, Lima, Peru
| | - Vicente A. Benites-Zapata
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
| | - Adrian V. Hernandez
- Unidad de Revisiones Sistemáticas y Meta-Análisis, Guías de Práctica Clínica y Evaluaciones de Tecnología Sanitaria, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
- Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Mansfield, CT, USA
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Jia Y, Song T, Li Z, Zhou L, Chen S. The Relationship Between Triglyceride Glucose Index and Vitamin D in Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes 2022; 15:511-525. [PMID: 35221702 PMCID: PMC8865864 DOI: 10.2147/dmso.s348845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/04/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The study aimed to investigate the relationship between 25-hydroxyvitamin D [25(OH) D] and triglyceride glucose index (TyG) levels in male and female patients with type 2 diabetes mellitus (T2DM). PATIENTS AND METHODS This cross-sectional study recruited 592 patients with type 2 diabetes. The subjects were divided into the non-vitamin D deficiency group [25(OH)D≥20ng/mL] and the vitamin D deficiency group [25(OH)D<20ng/mL]. The triglyceride glucose (TyG) index is calculated using the following formula, ln[fasting triglycerides (mg/dL)*fasting blood glucose (mg/dL)/2]. Participants were divided into high TyG group and low TyG group, with the median of TyG as the boundary. All participants were divided into male and female groups and normal Body mass index (BMI) and high BMI groups, and then divided into high TyG group and low TyG group. RESULTS We found that TyG levels are independently and negatively correlated with vitamin D levels in male patients with T2DM. In the female group, there was no significant correlation between TyG and vitamin D levels, regardless of an adjusted or unadjusted confounding factor. Subgroup analysis showed that the correlation between TyG and the risk of vitamin D deficiency in the normal BMI group was significantly stronger than that in the high BMI group. CONCLUSION This study indicates that vitamin D deficiency is related to high TyG level in patients with T2DM for males, and this relationship is not significant for female patients. The risk of vitamin D deficiency is significantly correlated with high TyG level in normal BMI group. However, there was no statistically significant difference between TyG level and the risk of vitamin D deficiency in the high BMI group. Difference between TyG level and the risk of vitamin D deficiency.
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Affiliation(s)
- Yujiao Jia
- Graduate School of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Tiantian Song
- Shijiazhuang Second Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Zelin Li
- Graduate School of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Linling Zhou
- Graduate School of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
| | - Shuchun Chen
- Graduate School of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
- Hebei Key Laboratory of Metabolic Diseases, Shijiazhuang, Hebei, People’s Republic of China
- Correspondence: Shuchun Chen, Department of Endocrinology, Hebei General Hospital, 348 Heping West Road, Shijiazhuang, Hebei, 050051, People’s Republic of China, Tel/Fax +86 31185988406, Email
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Ahmadi SAY, Shirzadegan R, Mousavi N, Farokhi E, Soleimaninejad M, Jafarzadeh M. Designing a Logistic Regression Model for a Dataset to Predict Diabetic Foot Ulcer in Diabetic Patients: High-Density Lipoprotein (HDL) Cholesterol Was the Negative Predictor. J Diabetes Res 2021; 2021:5521493. [PMID: 33816634 PMCID: PMC7994070 DOI: 10.1155/2021/5521493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/24/2021] [Accepted: 03/09/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Although the risk factors for diabetic neuropathy and diabetic foot ulcer have been detected, there was no practical modeling for their prediction. We aimed to design a logistic regression model on an Iranian dataset to predict the probability of experiencing diabetic foot ulcers up to a considered age in diabetic patients. METHODS The present study was a statistical modeling on a previously published dataset. The covariates were sex, age, body mass index (BMI), fasting blood sugar (FBS), hemoglobin A1C (HbA1C), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), insulin dependency, and statin use. The final model of logistic regression was designed through a manual stepwise method. To study the performance of the model, an area under receiver operating characteristic (AUC) curve was reported. A scoring system was defined according to the beta coefficients to be used in logistic function for calculation of the probability. RESULTS The pretest probability for the outcome was 30.83%. The final model consisted of age (β1 = 0.133), BMI (β2 = 0.194), FBS (β3 = 0.011), HDL (β4 = -0.118), and insulin dependency (β5 = 0.986) (P < 0.1). The performance of the model was definitely acceptable (AUC = 0.914). CONCLUSION This model can be used clinically for consulting the patients. The only negative predictor of the risk is HDL cholesterol. Keeping the HDL level more than 50 (mg/dl) is strongly suggested. Logistic regression modeling is a simple and practical method to be used in the clinic.
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Affiliation(s)
| | - Razieh Shirzadegan
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Nazanin Mousavi
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ermia Farokhi
- Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | | | - Mehrzad Jafarzadeh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
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