Hemoglobin A1c predicts healing rate in diabetic wounds.
Hemoglobin A1c predicts healing rate in diabetic wounds.
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DOI：
10.1038/jid.2011.176
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发表时间：
2011-10
影响因子：
6.5
通讯作者：
Garza, Luis A.
中科院分区：
文献类型：
--
作者：
Christman, Andrea L.;Selvin, Elizabeth;Margolis, David J.;Lazarus, Gerald S.;Garza, Luis A.
腿部伤口是糖尿病的主要并发症。血红蛋白A1c(HbA1c)反映2-3个月的血糖，是监测糖尿病患者血糖的标准指标，但研究结果并未表明HbA1c与伤口愈合之间存在一致的联系。我们假设HbA1c升高与伤口愈合不良最相关。为了验证这一假设，我们对在约翰霍普金斯创伤中心接受治疗的183名糖尿病患者进行了一项回溯性队列研究。我们的主要结果是创面愈合率(cm2/天)。使用校准的数字图像示踪来测量伤口面积。我们使用控制个体内伤口聚集的多元线性回归模型和其他常见的临床变量来估计愈合率系数。研究人群中45%为女性，41%为黑人，平均年龄为61岁。平均HbA1c为8.0%，平均每人有2.3个创面(共310个创面)。在所有评估的指标中，只有HbA1c与创面愈合率显著相关。特别是，HbA1c每增加1.0个百分点，每日创面愈合率下降0.028 cm~2/天(95%CI：0.003，0.0054，p=0.027)。我们的结果表明，糖化血红蛋白评估的血糖水平可能是预测糖尿病患者伤口愈合率的重要生物标志物。
Lower-extremity wounds are a major complication of diabetes. Hemoglobin A1c (HbA1c) reflects glycemia over 2–3 months and is the standard measure used to monitor glycemia in diabetic patients, but results from studies have not shown a consistent association of HbA1c with wound healing. We hypothesized that elevated HbA1c would be most associated with poor wound healing. To test this hypothesis we conducted a retrospective cohort study of 183 diabetic individuals treated at the Johns Hopkins Wound Center. Our primary outcome was wound-area healing rate (cm2/day). Calibrated tracings of digital images were used to measure wound area. We estimated coefficients for healing rate using a multiple linear regression model controlling for clustering of wounds within individuals and other common clinic variables. The study population was 45% female and 41% black with mean age of 61 years. Mean HbA1c was 8.0% and there were 2.3 wounds per individual (310 wounds total). Of all measures assessed, only HbA1c was significantly associated with wound-area healing rate. Specifically, for each 1.0% point increase in HbA1c, the daily wound-area healing rate decreased by 0.028 cm2/day (95% CI: 0.003, 0.0054, p=0.027). Our results suggest that glycemia, as assessed by HbA1c, may be an important biomarker in predicting wound healing rate in diabetic patients.
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影响因子：
5.9
作者：
Margolis, DJ;Allen-Taylor, L;Berlin, JA
通讯作者：
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影响因子：
16.2
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通讯作者：
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影响因子：
2.7
作者：
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通讯作者：
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