Charcot Arthropathy Risk Elevation in the Obese Diabetic Population - 20/08/11
, Elly Budiman-Mak, MD c, e, Todd A. Lee, PharmD, PhD c, d, Kevin B. Weiss, MD, MPH d, f
Requests for reprints should be addressed to Min-Woong Sohn, PhD, Hines VA Hospital, 5000 S. 5th Avenue (151H), Hines, IL 60141-3030Abstract |
Purpose |
To examine the association of obesity, peripheral neuropathy, and other risk factors with the Charcot arthropathy incidence rate in a large diabetic population.
Methods |
The Department of Veterans Affairs inpatient and outpatient administrative datasets were used to identify persons with diabetes in 2003. Logistic regressions were used to model the likelihood of a person developing Charcot arthropathy as a function of individual characteristics, obesity, peripheral neuropathy, diabetic control, and comorbidities.
Results |
Of Veterans Affairs users with diabetes, 652 (0.12%) were newly diagnosed with Charcot arthropathy in 2003. Compared with persons without obesity or peripheral neuropathy, those with obesity alone were approximately 59% more likely, those with neuropathy alone were 14 times more likely, and those with both obesity and neuropathy were 21 times more likely to develop Charcot arthropathy. Ages 55 to 64 years, diabetes duration 6 years or more, hemoglobin-A1c 7% or more, renal failure, arthritis, and deficiency anemia also were associated with an increased incidence of Charcot arthropathy.
Conclusion |
Obesity is significantly associated with an increased incidence of Charcot arthropathy independently of other risk factors. When obesity is combined with neuropathy, the Charcot arthropathy incidence rate increases multiplicatively. Prevention and detection of Charcot arthropathy should take the interaction between obesity and neuropathy into consideration.
Le texte complet de cet article est disponible en PDF.Keywords : Charcot arthropathy, Disease-disease interaction, Diabetes, Peripheral neuropathy
Plan
| Financial support was received from the Center for Management of Complex Chronic Care, Hines VA Hospital, Hines, Illinois (LIP 42-512; Elly Budiman-Mak, MD, Principal Investigator). The article presents the findings and conclusions of the authors; it does not necessarily represent the Department of Veterans Affairs or Health Services Research and Development Service. The authors have no financial or personal conflict of interest to declare. |
Vol 121 - N° 11
P. 1008-1014 - novembre 2008 Retour au numéro
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