Details

Autor(en) / Beteiligte

• Huang, Xiuxian
• Deng, Licai
• Huang, Jianhao
• Sun, Jingxia
• Wang, Qiu
• Mo, Jiacheng
• Zhai, Zhenwei
• Nong, Yuechou
• Lu, Wensheng

Titel

The Ratio of Serum Uric Acid to Glycosylated Haemoglobin as a Predictor of All-Mortality in Elderly Patients with Diabetic Foot Ulcers: A Longitudinal Cohort Study

Ist Teil von

• Diabetes, metabolic syndrome and obesity, 2023-09, Vol.16, p.2779-2790

Ort / Verlag

Dove Medical Press Limited

Erscheinungsjahr

2023

Link zum Volltext

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Aim: To clarify the relationship between serum uric acid (UA) and glycosylated hemoglobin (UA/HbAlc) ratio and all-cause mortality in patients with diabetic foot ulcers (DFUs). Methods: A total of 172 inpatients with DFUs (PEDIS grades 2-4) were eligible for inclusion in this study from 2018 to 2023. This was a retrospective, longitudinal cohort study. All subjects were followed up every 6 months for a median of 60 months. According to the cutoff value of the UA/HbAlc ratio of 39.07 obtained from ROC analysis, the participants were divided into two groups: low-level ([less than or equal to] 39.07, n = 107) and high-level (> 39.07, n = 65) groups. The correlation between UA/HbAlc ratio and all-cause mortality was also evaluated by Cox regression analysis TheKaplan-Meier survival curve analysis and Log rank tests were used to assess the incidence rates of all-cause mortality. The contribution rate of risk factors was estimated by the population-attributable risk percentage (FAR%) analysis. Results: ROC analysis showed that the optimal cutoff values for UA and the UA/HbAlc ratio were 372 [micro]mol/L and 39.07, respectively. Multivariate Cox regression analysis indicated that a high UA/HbAlc ratio (HR =4.63; 95% CI = 2.004-10.7, P < 0.001) was independently associated with a high risk of all-cause mortality in patients with DFUs. Stratified analysis indicated that subjects aged [greater than or equal to] 60 years had a greater risk of all-cause mortality associated with a high UA/HbAlc ratio (HR = 4.450; 95% CI = 1.711-11.574, P = 0.002). Kaplan-Meier survival analysis showed that all-cause mortality had a significant positive association with a high UA/HbAlc ratio (log-rank, P < 0.001) and a significant negative correlation with the lowered HbAlc level (< 6.5%) after a follow-up of 32 months (log-rank, P < 0.001). The population attributable risk percentage (FAR%) analysis suggested that the contribution rate of the high-level UA/HbAlc ratio to all-cause mortality was 33.7%, which was much greater than the 19.69% of UA. Conclusion: In brief, our study showed that for every 1.0% increase in the UA/HbAlc ratio, the all-cause mortality rate in elderly patients with DFUs aged > 60 years increased by 3.45-fold. For elderly patients with DFUs, a safe and effective strategy to reduce all-cause mortality is to strictly control serum UA levels to < 372 |xmol/L and appropriately loosen the control goal of HbAlc to > 6.5%. Keywords: diabetic foot ulcer, uric acid to glycosylated hemoglobin ratio, all-cause mortality