| Original Articles : Relationship between clinical course and measures of atherosclerosis in diabetic foot |
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Kyoung Min Kim, Se Hun Kang, Dong Hyeok Cho, Ho Cheol Kang, Dong Jin Chung, Min Young Chung |
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고려의대 구로병원 내과학 교실 |
| 원저 : 당뇨병성 족부병변에서 임상경과와 동맥경화증 지표와의 관계 |
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김경민, Se Hun Kang, Dong Hyeok Cho, Ho Cheol Kang, Dong Jin Chung, Min Young Chung |
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| Abstract |
Background : Although various factors may influence the outcome of diabetic foot ulcers in diabetic subjects, the severity of peripheral vascular disease (PVD) is the main independent risk factor for amputation. The carotid intima-medial thickness (IMT), ankle brachial pressure index (ABPI) and pulse wave velocity (PWV) have been used as noninvasive markers of PVD. The present study aims to examine the association of carotid IMT, ABPI and PWV with the risk of lower extremity amputation in diabetic foot patients.
Methods
: Total 114 diabetic patients (39 diabetic foot patients and 75 patients who didn't have diabetic foot) were participated for the study. Twenty four of diabetic foot patients underwent lower extremity amputation. Informations about past history, social habit and courses of diabetic foot were collected from the patients by means of a structured interview. We measured carotid IMT, ABPI and PWV.
Results
: The following characteristics were significantly related to the development of diabetic foot ulcers: male, smoker, alcohol drinker, longer diabetes duration, presence of diabetic chronic complications, lower ABPI (<0.9), increased mean IMT (>0.8 mm), increased PWV. Patients with amputation had lower HDL cholesterol, higher incidence of osteomyelitis and older age, compared with patients without amputation. We observed a significant association between mean carotid IMT and the rate of amputation in diabetic foot patients [odd ratio, 11.42 (95% confidence interval, 1.03～127.19)].
Conclusions
: This study suggests that measurement of carotid IMT as noninvasive index of atherosclerosis may be a useful indirect method in identifying diabetic foot patients who may have lower extremity amputation.(Korean J Med 70:361-370, 2006)
Key Words : Amputation, Diabetic foot, Intima-medial thickness |
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