AimsPedal medial arterial calcification (MAC) is frequently observed in individuals with diabetic foot ulcers (DFUs). However, the impact of pedal MAC on individuals with DFUs remains uncertain. The main aim of this study was to evaluate the association between pedal MAC with amputation and mortality outcomes.MethodsA prospective, observational cohort study was conducted at West China Hospital from January 2012 to December 2021. Logistic regression analyses, Kaplan–Meier survival method, and Cox proportional hazards models were employed to evaluate the relationship between pedal MAC and amputation as well as mortality.ResultsA total of 979 patients were enrolled in the study. Peripheral artery disease (PAD) was observed in 53% of patients with DFUs, and pedal MAC was found in 8%. Over a median follow‐up of 46 (23–72) months, foot amputation was performed on 190 patients, and mortality occurred in 246 patients. Pedal MAC showed a significant association with amputation both in unadjusted analysis (odds ratio [OR] = 2.98, 95% confidence interval [CI] = 1.86–4.76, p < .001) and after adjusting sex, age, albumin levels, hemoglobin levels, and diabetic retinopathy status (OR 2.29, 95% CI 1.33–3.93, p = .003). The risk of amputation was found to be twofold higher in individuals with PAD and pedal MAC compared to those with PAD alone (OR 2.05, 95% CI 1.10–3.82, p = .024). Furthermore, the presence of pedal MAC was significantly associated with an increased risk of mortality (p = .005), particularly among individuals with DFUs but without PAD (HR 4.26, 95% CI 1.90–9.52, p < .001), rather than in individuals presenting with both DFUs and PAD.ConclusionThe presence of pedal MAC is significantly associated with both amputation and mortality in individuals with DFUs. Moreover, pedal MAC could provide additional value to predict amputation other than PAD.image

中文翻译：

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糖尿病足溃疡的足部内侧动脉钙化：截肢和死亡的重要危险因素

目的 糖尿病足溃疡 (DFU) 患者中经常观察到踏板内侧动脉钙化 (MAC)。然而，踏板 MAC 对 DFU 患者的影响仍不确定。本研究的主要目的是评估踏板 MAC 与截肢和死亡率结果之间的关联。方法 2012 年 1 月至 2021 年 12 月在华西医院进行了一项前瞻性观察性队列研究。Logistic 回归分析、Kaplan-Meier 生存法和采用Cox比例风险模型评估踏板MAC与截肢以及死亡率之间的关系。结果共有979名患者纳入研究。 53% 的 DFU 患者出现外周动脉疾病 (PAD)，8% 的患者出现足部 MAC。在中位随访 46 (23-72) 个月的时间里，190 名患者接受了足部截肢手术，246 名患者死亡。在未经调整的分析中，踏板 MAC 显示与截肢显着相关（比值比 [OR] = 2.98，95% 置信区间 [CI] = 1.86–4.76，p< .001）并在调整性别、年龄、白蛋白水平、血红蛋白水平和糖尿病视网膜病变状态后（OR 2.29，95% CI 1.33–3.93，p=.003）。研究发现，与仅患有 PAD 的患者相比，患有 PAD 和踏板 MAC 的患者截肢的风险高出两倍（OR 2.05，95% CI 1.10–3.82，p =.024）。此外，踏板 MAC 的存在与死亡风险增加显着相关（p= .005），尤其是患有 DFU 但没有 PAD 的个体（HR 4.26，95% CI 1.90–9.52，p< .001），而不是同时患有 DFU 和 PAD 的个体。结论 踏板 MAC 的存在与 DFU 个体的截肢和死亡率显着相关。此外，除了 PAD 之外，踏板 MAC 还可以为预测截肢提供额外的价值。图像