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首页> 外文期刊>The international journal of lower extremity wounds >HbA1c and Lower Extremity Amputation Risk in Patients With Diabetes: A Meta-Analysis
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HbA1c and Lower Extremity Amputation Risk in Patients With Diabetes: A Meta-Analysis

机译：糖尿病患者HbA1c和下肢截肢风险的Meta分析

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In this meta-analysis, we aimed to assess glycosylated hemoglobin (HbA1c) level and lower extremity amputation (LEA) risk in patients with diabetes. Systematic computerized searches of the PubMed and Web of Knowledge were performed. We compared HbA1c level between groups with LEA and without LEA by meta-analysis; we also examined the dose-response relationship between HbA1c level and LEA risk. Sixteen studies were included in the meta-analysis. Eleven studies with 43566 patients compared HbA1c between groups with and without LEA. The mean HbA1c (%) ranged from 8.3 to 12.5 in the group with LEA and from 7.4 to 11.3 in the group without LEA. The pooled weighted mean difference was 1.110 (95% confidence interval = 0.510-1.709; Z = 3.63, P = .008). The funnel plot was symmetrical, and Begg's test (z = 0.00, P = 1.000) and Egger's test (t = -0.02, P = .984) suggested no significant publication bias. Six studies with 109933 patients included in the dose-response meta-analysis. The LEA incidence ranged from 0.3% to 14.6% between different HbA1c levels. Dose-response meta-analysis showed statistically significant association between HbA1c and LEA risk ((2) = 65.51, P = .000). In linear model, the odds ratio for LEA incidence was 1.229 (95% confidence interval = 1.169-1.292) for every 1% HbA1c increase. In the spline model, the odds ratio of LEA risk increased with HbA1c levels, especially when HbA1c ranged from 5% to 9%. Our meta-analysis indicates that high level of HbA1c is an important risk factor for LEA in patients with diabetes. This evidence supports the strategy for lowering glucose levels to reduce amputation in patients with diabetes.
机译：在本荟萃分析中，我们旨在评估糖尿病患者的糖基化血红蛋白（HbA1c）水平和下肢截肢（LEA）风险。对PubMed和Web of Knowledge进行了系统的计算机搜索。我们通过荟萃分析比较了有LEA组和无LEA组之间的HbA1c水平。我们还检查了HbA1c水平与LEA风险之间的剂量反应关系。荟萃分析包括十六项研究。包含43566例患者的11项研究比较了有无LEA组之间的HbA1c。有LEA组的平均HbA1c（％）为8.3至12.5，无LEA组的平均HbA1c为7.4至11.3。合并的加权平均差为1.110（95％置信区间= 0.510-1.709; Z = 3.63，P = 0.008）。漏斗图是对称的，Begg检验（z = 0.00，P = 1.000）和Egger检验（t = -0.02，P = .984）表明没有明显的偏倚。剂量反应荟萃分析包括六项针对109933名患者的研究。在不同的HbA1c水平之间，LEA发生率在0.3％至14.6％之间。剂量反应荟萃分析显示HbA1c与LEA风险之间具有统计学意义的关联性（（2）= 65.51，P = .000）。在线性模型中，每增加1％HbA1c，LEA发生率的比值比为1.229（95％置信区间= 1.169-1.292）。在样条模型中，LEA风险的几率随HbA1c水平的升高而增加，尤其是当HbA1c在5％至9％的范围内时。我们的荟萃分析表明，高水平的HbA1c是糖尿病患者LEA的重要危险因素。该证据支持降低葡萄糖水平以减少糖尿病患者截肢的策略。

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