背景:Charcot神经关节病(CN)的病理生理学尚不清楚。有许多假设,但这些不是排他性的。在临床表现中,这种并发症与糖尿病引起的神经病的符号学相交,如外周血管过度化和动静脉分流的出现。EPICHAR研究是一个尚未发表的队列,研究对象是患有CN的糖尿病患者(处于活动期或慢性期)。根据EPICHAR研究的结果,这项研究旨在调查高血糖率的降低是否伴随CN活跃期的开始.
方法:在诊断为活动性CN(M0)前3个月(M3)和6个月(M6)评估血红蛋白A1c(HbA1c)水平。
结果:在2019年1月至12月期间,来自参与本研究的31个中心(30个在法国,1个在比利时)的103名糖尿病患者被纳入。参与者的平均年龄为60.2±12.2岁;绝大多数是患有2型糖尿病(75.5%)的男性(71.8%)。平均HbA1c水平在M6(中位数7.70;Q1,Q3:7.00,8.55)和M3(中位数7.65;Q1,Q3:6.90,8.50)之间显着下降(p=0.012),以及M6和M0之间(中位数7.40;Q1,Q3:6.50,8.50)(p=0.014)。M3和M0之间没有发现显着差异(p=0.072)。
结论:HbA1c水平的显著降低似乎伴随着CN活跃期的开始。
背景:NCM03744039.
BACKGROUND: The pathophysiology of Charcot
neuroarthropathy (CN) remains unclear. There are a number of hypotheses but these are not exclusive. In its clinical presentation, this complication intersects with the semiology of diabetic-induced neuropathy, such as peripheral hypervascularization and the appearance of arteriovenous shunt. The EPICHAR
study is as yet an unpublished cohort of people living with diabetes complicated by CN (in active or chronic phase). Based on the findings of the EPICHAR
study, this
study aimed to investigate whether a reduction in the rate of hyperglycemia accompanies the onset of an active phase of CN.
METHODS: Hemoglobin A1c (HbA1c) levels were assessed 3 months (M3) and 6 months (M6) before the diagnosis of active CN (M0).
RESULTS: 103 patients living with diabetes and presenting active CN were included between January and December 2019 from the 31 centers participating in this
study (30 in France and 1 in Belgium). The mean age of the participants was 60.2±12.2 years; the vast majority were men (71.8%) living with type 2 diabetes (75.5%). Mean HbA1c levels significantly declined between M6 (median 7.70; Q1, Q3: 7.00, 8.55) and M3 (median 7.65; Q1, Q3: 6.90, 8.50) (p=0.012), as well as between M6 and M0 (median 7.40; Q1, Q3: 6.50, 8.50) (p=0.014). No significant difference was found between M3 and M0 (p=0.072).
CONCLUSIONS: A significant reduction in HbA1c levels seems to accompany the onset of the active phase of CN.
BACKGROUND: NCM03744039.