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Abstract：
OBJECTIVE: We aimed to explore the association between albuminuria and clinical outcomes in patients with diabetic foot osteomyelitis (DFO).
METHODS: This is an observational retrospective study and a total of 202 inpatients with DFO were eligible for inclusion in our study. Based on urine albumin-creatinine ratio (UACR), the patients were divided into three groups: normoalbuminuria group, microalbuminuria group and macroalbuminuria group. The data collected include demographics data, laboratory data, clinical diagnostic data, diabetic foot examination and clinical visit data. The association was then evaluated between albuminuria and all-cause mortality, major cardiovascular adverse events (MACE) and mixed endpoint events.
RESULTS: The mean age was 60.3 years, 62.9% were male and 45.05% were urinary protein-positive. The incidence rates of all-cause mortality, MACE and mixed endpoint events related to elevated UACR were significantly increased in patients with DFO (all P for trend < 0.01). After adjusting for confounders, compared with normoalbuminuria group, the risk of all-cause mortality, MACE and mixed endpoint events in the microalbuminuria group increased by 81.8%, 135.4% and 136.4%, respectively. The risk of all-cause mortality, MACE and mixed endpoint events in the macroalbuminuria group increased by 246.2%, 145.1% and 252.3%, respectively. The population attributable risk percentage (PAR%) suggested that 50.16% of all-cause mortality, 47.85% of MACE and 59.11% of mixed endpoint events could be attributed to the elevated UACR. Meanwhile, compared with normoalbuminuria, those with microalbuminuria or macroalbuminuria have lower apoA1 and ABI, higher SCr and higher incidence rate of CHD, hindfoot infection and severe infection (all P < 0.05).
CONCLUSIONS: In patients with DFO, the UACR level is associated with all-cause mortality, MACE and mixed endpoint events and elevated UACR levels increase the risk of all-cause mortality, MACE and mixed endpoint events.
METHODS: This is an observational retrospective study and a total of 202 inpatients with DFO were eligible for inclusion in our study. Based on urine albumin-creatinine ratio (UACR), the patients were divided into three groups: normoalbuminuria group, microalbuminuria group and macroalbuminuria group. The data collected include demographics data, laboratory data, clinical diagnostic data, diabetic foot examination and clinical visit data. The association was then evaluated between albuminuria and all-cause mortality, major cardiovascular adverse events (MACE) and mixed endpoint events.
RESULTS: The mean age was 60.3 years, 62.9% were male and 45.05% were urinary protein-positive. The incidence rates of all-cause mortality, MACE and mixed endpoint events related to elevated UACR were significantly increased in patients with DFO (all P for trend < 0.01). After adjusting for confounders, compared with normoalbuminuria group, the risk of all-cause mortality, MACE and mixed endpoint events in the microalbuminuria group increased by 81.8%, 135.4% and 136.4%, respectively. The risk of all-cause mortality, MACE and mixed endpoint events in the macroalbuminuria group increased by 246.2%, 145.1% and 252.3%, respectively. The population attributable risk percentage (PAR%) suggested that 50.16% of all-cause mortality, 47.85% of MACE and 59.11% of mixed endpoint events could be attributed to the elevated UACR. Meanwhile, compared with normoalbuminuria, those with microalbuminuria or macroalbuminuria have lower apoA1 and ABI, higher SCr and higher incidence rate of CHD, hindfoot infection and severe infection (all P < 0.05).
CONCLUSIONS: In patients with DFO, the UACR level is associated with all-cause mortality, MACE and mixed endpoint events and elevated UACR levels increase the risk of all-cause mortality, MACE and mixed endpoint events.
摘要：
目的：我们旨在探讨蛋白尿与糖尿病足骨髓炎（DFO）患者临床结局之间的关系。
方法：这是一项观察性回顾性研究，共202例DFO患者纳入本研究。根据尿白蛋白-肌酐比值（UACR），将患者分为三组:正常白蛋白尿组,微量白蛋白尿组和大量白蛋白尿组。收集的数据包括人口统计数据，实验室数据,临床诊断数据，糖尿病足检查和临床访视资料。然后评估白蛋白尿和全因死亡率之间的关联，主要心血管不良事件（MACE）和混合终点事件。
结果：平均年龄为60.3岁，62.9％为男性，45.05％为尿蛋白阳性。全因死亡率的发生率，DFO患者MACE和与UACR升高相关的混合终点事件显著增加(P均<0.01)。在调整了混杂因素后，与正常白蛋白尿组相比，全因死亡的风险，微量白蛋白尿组的MACE和混合终点事件增加了81.8%，135.4%和136.4%，分别。全因死亡的风险，大量白蛋白尿组的MACE和混合终点事件增加了246.2％，145.1%和252.3%,分别。人口归因风险百分比（PAR％）表明全因死亡率的50.16％，47.85%的MACE和59.11%的混合终点事件可归因于UACR升高。同时,与正常白蛋白尿相比，那些与微量白蛋白尿或大量白蛋白尿有较低的apoA1和ABI，SCr较高，CHD发病率较高，后足感染和严重感染(均P<0.05)。
结论：在DFO患者中，UACR水平与全因死亡率相关，MACE和混合终点事件以及UACR水平升高会增加全因死亡率的风险，MACE和混合端点事件。
方法：这是一项观察性回顾性研究，共202例DFO患者纳入本研究。根据尿白蛋白-肌酐比值（UACR），将患者分为三组:正常白蛋白尿组,微量白蛋白尿组和大量白蛋白尿组。收集的数据包括人口统计数据，实验室数据,临床诊断数据，糖尿病足检查和临床访视资料。然后评估白蛋白尿和全因死亡率之间的关联，主要心血管不良事件（MACE）和混合终点事件。
结果：平均年龄为60.3岁，62.9％为男性，45.05％为尿蛋白阳性。全因死亡率的发生率，DFO患者MACE和与UACR升高相关的混合终点事件显著增加(P均<0.01)。在调整了混杂因素后，与正常白蛋白尿组相比，全因死亡的风险，微量白蛋白尿组的MACE和混合终点事件增加了81.8%，135.4%和136.4%，分别。全因死亡的风险，大量白蛋白尿组的MACE和混合终点事件增加了246.2％，145.1%和252.3%,分别。人口归因风险百分比（PAR％）表明全因死亡率的50.16％，47.85%的MACE和59.11%的混合终点事件可归因于UACR升高。同时,与正常白蛋白尿相比，那些与微量白蛋白尿或大量白蛋白尿有较低的apoA1和ABI，SCr较高，CHD发病率较高，后足感染和严重感染(均P<0.05)。
结论：在DFO患者中，UACR水平与全因死亡率相关，MACE和混合终点事件以及UACR水平升高会增加全因死亡率的风险，MACE和混合端点事件。
