Aims/IntroductionThis study aimed to assess if patients can be divided into different strata, and to explore if these correspond to the risk of diabetic foot complications.Materials and MethodsA set of 28 demographic, vascular, neurological and biomechanical measures from 2,284 (1,310 men, 974 women) patients were included in this study. A two‐step cluster analysis technique was utilised to divide the patients into groups, each with similar characteristics.ResultsOnly two distinct groups: group 1 (n = 1,199; 669 men, 530 women) and group 2 (n = 1,072; 636 men, 436 women) were identified. From continuous variables, the most important predictors of grouping were: ankle vibration perception threshold (16.9 ± 4.1 V vs 31.9 ± 7.4 V); hallux vibration perception threshold (16.1 ± 4.7 V vs 33.1 ± 7.9 V); knee vibration perception threshold (18.2 ± 5.1 V vs 30.1 ± 6.5 V); average temperature sensation threshold to cold (29.2 ± 1.1°C vs 26.7 ± 0.7°C) and hot (35.4 ± 1.8°C vs 39.5 ± 1.0°C) stimuli, and average temperature tolerance threshold to hot stimuli at the foot (43.4 ± 0.9°C vs 46.6 ± 1.3°C). From categorical variables, only impaired sensation to touch was found to have importance at the highest levels: 87.4% of those with normal sensation were in group 1; whereas group 2 comprised 95.1%, 99.3% and 90.5% of those with decreased, highly‐decreased and absent sensation to touch, respectively. In addition, neuropathy (monofilament) was a moderately important predictor (importance level 0.52) of grouping with 26.2% of participants with neuropathy in group 1 versus 73.5% of participants with neuropathy in group 2. Ulceration during follow up was almost fivefold higher in group 2 versus group 1.ConclusionsImpaired sensations to temperature, vibration and touch were shown to be the strongest factors in stratifying patients into two groups with one group having almost 5‐fold risk of future foot ulceration compared to the other.

中文翻译：

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将患者分为不同糖尿病足溃疡风险组时，哪些特征最重要？

目的/简介本研究旨在评估患者是否可以分为不同的阶层，并探讨这些阶层是否与糖尿病足并发症的风险相对应。材料和方法来自 2,284 名患者（1,310 名男性，本研究纳入了 974 名女性患者。利用两步聚类分析技术将患者分组，每个组具有相似的特征。结果只有两个不同的组：第 1 组（n= 1,199； 669 名男性，530 名女性）和第 2 组（n= 1,072；确定了 636 名男性、436 名女性。从连续变量来看，分组最重要的预测因素是： 踝关节振动感知阈值（16.9 ± 4.1 V vs 31.9 ± 7.4 V）；拇趾振动感知阈值（16.1 ± 4.7 V vs 33.1 ± 7.9 V）；膝盖振动感知阈值（18.2 ± 5.1 V 与 30.1 ± 6.5 V）；对冷（29.2 ± 1.1°C vs 26.7 ± 0.7°C）和热（35.4 ± 1.8°C vs 39.5 ± 1.0°C）刺激的平均温度感觉阈值，以及足部对热刺激的平均温度耐受阈值（43.4 ± 0.9°C 与 46.6 ± 1.3°C）。从分类变量来看，只有触觉受损才在最高水平上具有重要性：87.4% 感觉正常的人属于第一组；而第 2 组分别包括 95.1%、99.3% 和 90.5% 的触觉减弱、高度减弱和消失的患者。此外，神经病变（单丝）是分组的中等重要预测因子（重要性级别为 0.52），第 1 组中患有神经病变的参与者为 26.2%，而第 2 组中为 73.5% 的患有神经病变的参与者。随访期间的溃疡率几乎是第 1 组的五倍2 与组 1 的比较。 结论 对温度、振动和触觉的感觉受损是将患者分为两组的最强因素，其中一组未来足部溃疡的风险几乎是另一组的 5 倍。