Risk of diabetes-related amputation in South Asians vs. Europeans in the UK
Risk of diabetes-related amputation in South Asians vs. Europeans in the UK
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DOI：
10.1046/j.1464-5491.2002.00583.x
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发表时间：
2002-02-01
影响因子：
3.5
通讯作者：
Boulton, AJM
中科院分区：
文献类型：
--
作者：
Chaturvedi, N;Abbott, CA;Boulton, AJM
目的比较南亚人和欧洲人糖尿病相关截肢的风险和危险因素。方法：这是一项基于人群的病例对照研究，基于英国博尔顿、奥尔德姆和曼彻斯特中部的卫生区。从以初级保健为基础的西北糖尿病足研究数据库中选择1992年至1997年间进行糖尿病相关截肢的病例（n = 172）和未截肢的糖尿病对照（n = 376）。风险因素数据也被收集。结果南亚人与欧洲人相比，诊断年龄校正截肢的优势比（OR）为0.26,95%可信区间（CI） 0.11 ~ 0.65, P = 0.004。在对照人群中，南亚人患外周血管疾病（PVD）（9%对24%，P = 0.02）、神经病变（30%对54%，P = 0.003）的可能性低于欧洲人，曾经吸烟的可能性更低（31%对57%，P = 0.03）。当这些因素加入到模型中时，OR减弱为0.84,95% CI 0.23-3.08, P = 0.8。结论：南亚糖尿病患者截肢的风险约为欧洲人的四分之一。这主要是由于南亚人的心血管疾病和神经病变发病率较低，部分原因与吸烟率较低有关。南亚人预防PVD和神经病变的原因值得进一步探讨。
Aims To compare the risk of and risk factors for diabetes-related amputation in South Asians and Europeans.Methods This was a population-based case control study based in the health districts of Bolton, Oldham and Central Manchester in the UK. Cases with diabetes-related amputation performed between 1992 and 1997 (n = 172) and controls with diabetes and no amputation (n = 376) were selected from the primary care-based North-west Diabetes Foot Study database. Risk factor data were also collected.Results Age at diagnosis adjusted odds ratio (OR) of amputation in South Asians compared with Europeans was 0.26, 95% confidence interval (CI) 0.11-0.65, P = 0.004. In the control population, South Asians were less likely than Europeans to have peripheral vascular disease (PVD) (9% vs. 24%, P = 0.02), neuropathy (30% vs. 54%, P = 0.003), and less likely to have ever been smokers (31% vs. 57%, P = 0.03). When these factors were added to the model, the OR was attenuated to 0.84, 95% CI 0.23-3.08, P = 0.8.Conclusions South Asians with diabetes have about a quarter of the risk of amputation of Europeans. This is mostly explained by low rates of PVD and neuropathy in South Asians, in part associated with low rates of smoking. The reasons for the South Asian protection from both PVD and neuropathy deserve further exploration.