Clinical Research On The Relationship Between The Different Wagner Grades Of Diabetic Foot And Thyroid Function In Patients With Type 2 Diabetes

Part 1.Analysis of Risk Factors for Type 2 Diabetic FootObjective To investigate the risk factors of diabetic foot in patients with type 2 diabetes occurrence and development.Methods A retrospective study was carried out on 481 type 2 diabetic foot(DF) patients and 445 type 2 diabetes mellitus of non‐foot disease(NDF) in the Department of Endocrinology of Chinese PLA Hospital No.306 from June 2009 to June 2015. Clinical data, biochemical examination, endocrine examination, etc were analyzed in the group of NDF,G1(Wagner1‐2 levels) and G2(Wagner3‐5 levels). Comparison of clinical data between the groups:age,gender,the duration of diabetes, height, weight, days of stay hospital, systolic blood pressure(SBP),diastolic blood pressure(DBP),diabetic nephropathy(DN), d iabetic retinopathy(DR), diabetic peripheral neuropathy(DPN),ankle brachial index(ABI), aortic stiffness,hypoglycemic therapy,amputation case,et al.biochemical indicators: fasting plasma glucose(FPG),2‐hour postprandial plasma glucose(2h PPG),total protein(TP),albumin(Alb),glycosylated hemoglobin(Hb A1c),total cholesterol(TC),triglycerides(TG),high‐density lipoprotein cholesterol(HDL‐C),low‐density lipoprotein cholesterol(LDL‐C),high sensitive C‐reactive protein(hs‐CRP), Insulin‐like growth factor‐1( I GF‐1), urine albumin/creatinine ratio(UACR).Endocrine examination: fasting C‐peptide,2‐hour postprandial C‐peptide, total triiodothyronine(TT3),(total thyroxine,TT4),free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH),thyroglobulin antibody(TGAb),thyromicrosome antibody(TMAb).Analyzed the thyroid function status by SPSS 21.0.Results The patients in DFs were significantly higher than in the NDFs in age, duration of diabetes, SBP,hs‐CRP,2h PPG, Hospitalization days, The proportion of men, DN, DR, aortic stiffness, UACR( all P for trend <0.05). The patients in DFs were significantly lower than in the NDFs in IGF‐1,BMI,Alb, TC, TG,2‐hour C‐peptide, ABI(all P for trend <0.05).Two groups of patients of DBP,Hb A1 c,FPG,HDL‐C,LDL‐C,fasting C peptide differences had no statistical significance(all P for trend>0.05).Multivariate stepwise regression ananlysis indicated that TT3 and TT4 were associated with DF significantly(a ll P for trend <0.05).Geder,hs‐CRP,Alb,TP,2h PPG were also associated with DF significantly(all P for trend <0.05).Conclusion Geder,age,TP,Alb,UACR,2h PPG,Hb A1 c,fasting C peptide,hs‐CRP,IGF‐1,TT4,TT3 have an important impact on the development.Part 2. Clinical Research on the Relationship Between the Different Wagner Grades of Diabetic Foot and Thyroid Function in Patients with Type 2 DiabetesObjective To explore the relationship between the severity of diabetic foot disease(Wagner1‐5 levels) and thyroid function.Methods A retrospective study was carried out on 481 type 2 diabetic foot(DF) patients and 445 type 2 diabetes mellitus of non‐foot disease(NDF) in the Department of Endocrinology of Chinese PLA Hospital No.306 from June 2009 to June 2015. Analysis of thyroid function between the DF and NDF were did.Then analyze the status of thyroid function and types among the sub groups Wagner 1,2,3,4‐5.The data were ananlyzde by SPSS 21.0.Results The differences of TT3、FT3、TT4 in DFs and NDFs had statistically significance by t test(all P for trend <0.01), and further analysis results showed that within the DF group, with higher graded Wagner, TT3 and FT3 value more and more low, the difference were statistically significant(all P for trend <0.01). The ratio of ESS was obviously higher with the increase of Wagner grades(Each ratio were 2%,2.55%,9.24%,18.33%,t=24.455, P<0.05). With ESS of diabetic patients in the hospital for a long time.Conclution The prevalence of thyroid dysfunction is higher in DFs, mainly as the ESS. The prevalence of ESS obviously increases in Wagner grade 3 and above which implies the severity of DFs. Through the detection of thyroid function, can evaluate the condition and judge the prognosis and strive for the best treatment effect on DF.