Study Of Prevalence And Predisposing Factors Of Toenail Onychomycosis In Patients With Type2Diabetes Mellitus In Chongqing

Objective: To explore the prevalence of toenail onychomycosis in thepatients with type2diabetes mellitus (T2DM) and non-diabetes inChongqing. Analyze the predisposing factors of toenail onychomycosis inpatients with T2DM and its relationship with foot ulcers in T2DM.Methods:374patients with T2DM hospitalized in the Department ofEndocrinology from July2011to January2013and300non-diabetessubjects as the control group (including132spouses of those T2DMpatients and168subjects of the physical examination in medicalexamination center) were recruited. Specimens from the toenail scraps ofthe subjects were examined by fungus microscopy. The followinginformation was obtained: gender, age, duration of diabetes，hypertension,smoking history, family history of onychomycosis, coronary heart diseasehistory, cerebral infarction history, body mass index(BMI), foot ulcers inT2DM, the value of glycosylated hemoglobin(HbAlc), total cholesterol(TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c), glucose, blood pressure,complication of diabetes, tinea pedis by questionnaires, physicalexamination and consulting medical records. SPSS17.0was used forstatistical analysis.Results: The mean age of diabetes and control group was62.93±11.56years and57.76±12.51years, respectively. The prevalence rates of toenailonychomycosis were49.5%and29.6%in the diabetics and control group,respectively. When aged less than55, the prevalence rates of toenailonychomycosis were not significantly different between the two groups(>0.05); However, while older than55, the prevalence rates of toenailonychomycosis in the T2DM was higher than control group(P<0.05). Age,the prevalence rates of diabetic peripheral neuropathy, hypertension, tineapedis and patients with family history of onychomycosis in toenailonychomycosis group was higher in diabetic patients with toenailonychomycosis than these without toenail onychomycosis. Logisticregression analysis demonstrated that the predisposing factors for toenailonychomycosis in the patients with T2DM included increasing age(OR=3.373,95%CI1.698~6.703, P=0.001), tinea pedis (OR=2.480,95%CI1.005~6.120, P=0.049), family history of onychomycosis (OR=2.643,95%CI1.416~4.934, P=0.002). Toenail onychomycosis not significantlyincrease the risk of foot ulcer in T2DM (P=0.918, OR1.027,95%CI0.617~1.708). Conclusion: The prevalence rate of toenail onychomycosis is higherin T2DM than non-diabetes. The predisposing factors include increasingage, tinea pedis and family history of onychomycosis. Toenailonychomycosis may not be related with the foot ulcer in T2DM.