The relationship between at-risk foot and all-cause and cardiovascular mortality among the population with diabetes
BackgroundDiabetic foot (DF) is a common complication among people with diabetes, typically caused by peripheral neuropathy (PN) and/or peripheral arterial disease (PAD) of the lower limbs. The existing research mainly focuses on cases of diabetic foot ulcers, while the relationship between at-risk...
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Frontiers Media S.A.
2025-07-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1584949/full |
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| author | Zhe Wu Jin Dong Meng Li Chu Chu Bin Wang |
| author_facet | Zhe Wu Jin Dong Meng Li Chu Chu Bin Wang |
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| description | BackgroundDiabetic foot (DF) is a common complication among people with diabetes, typically caused by peripheral neuropathy (PN) and/or peripheral arterial disease (PAD) of the lower limbs. The existing research mainly focuses on cases of diabetic foot ulcers, while the relationship between at-risk foot and all-cause and cardiovascular mortality in the general U.S. population remains unclear.MethodsThis study utilized data from National Health and Nutrition Examination Survey (NHANES) 1999–2004 to conduct a cohort study. At-risk foot are defined as those in diabetic people who have concurrent PAD and/or PN, and without the presence of chronic ulcers in the lower extremities. Kaplan–Meier survival analysis and Multivariable Cox regression models were used to analyze the association between at-risk foot and all-cause and cardiovascular mortality, with subgroup analyses conducted.ResultsA total of 946 participants were included in the study, of which 301 had at-risk foot. The median follow-up time was 190 months. Multivariable Cox regression analysis showed that the all-cause mortality (HR: 2.050, 95% CI: 1.524, 2.758) and cardiovascular mortality (HR: 2.494, 95% CI: 1.809, 3.438) in at-risk foot people were significantly higher than in those without at-risk foot. Additionally, people with ischemic at-risk foot had a higher risk of mortality compared to those with non-ischemic neuropathic at-risk foot.ConclusionPatients with at-risk foot in the diabetic population are significantly associated with increased all-cause and cardiovascular mortality. Early diagnosis and intervention of PAD and PN in diabetes people are crucial for reducing mortality risk. |
| format | Article |
| id | doaj-art-4937775b6ebe4e3ea1a26ea927fb2021 |
| institution | Kabale University |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj-art-4937775b6ebe4e3ea1a26ea927fb20212025-08-20T03:51:19ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.15849491584949The relationship between at-risk foot and all-cause and cardiovascular mortality among the population with diabetesZhe Wu0Jin Dong1Meng Li2Chu Chu3Bin Wang4The First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, ChinaDepartment of Emergency, The Changqing District People's Hospital, Jinan, ChinaDepartment of Endocrine, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, ChinaInnovative Institute of Chinese Medicine and Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, ChinaDepartment of Vascular Surgery, The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, ChinaBackgroundDiabetic foot (DF) is a common complication among people with diabetes, typically caused by peripheral neuropathy (PN) and/or peripheral arterial disease (PAD) of the lower limbs. The existing research mainly focuses on cases of diabetic foot ulcers, while the relationship between at-risk foot and all-cause and cardiovascular mortality in the general U.S. population remains unclear.MethodsThis study utilized data from National Health and Nutrition Examination Survey (NHANES) 1999–2004 to conduct a cohort study. At-risk foot are defined as those in diabetic people who have concurrent PAD and/or PN, and without the presence of chronic ulcers in the lower extremities. Kaplan–Meier survival analysis and Multivariable Cox regression models were used to analyze the association between at-risk foot and all-cause and cardiovascular mortality, with subgroup analyses conducted.ResultsA total of 946 participants were included in the study, of which 301 had at-risk foot. The median follow-up time was 190 months. Multivariable Cox regression analysis showed that the all-cause mortality (HR: 2.050, 95% CI: 1.524, 2.758) and cardiovascular mortality (HR: 2.494, 95% CI: 1.809, 3.438) in at-risk foot people were significantly higher than in those without at-risk foot. Additionally, people with ischemic at-risk foot had a higher risk of mortality compared to those with non-ischemic neuropathic at-risk foot.ConclusionPatients with at-risk foot in the diabetic population are significantly associated with increased all-cause and cardiovascular mortality. Early diagnosis and intervention of PAD and PN in diabetes people are crucial for reducing mortality risk.https://www.frontiersin.org/articles/10.3389/fmed.2025.1584949/fulldiabetic footat-risk footperipheral arterial diseaseperipheral neuropathymortality |
| spellingShingle | Zhe Wu Jin Dong Meng Li Chu Chu Bin Wang The relationship between at-risk foot and all-cause and cardiovascular mortality among the population with diabetes Frontiers in Medicine diabetic foot at-risk foot peripheral arterial disease peripheral neuropathy mortality |
| title | The relationship between at-risk foot and all-cause and cardiovascular mortality among the population with diabetes |
| title_full | The relationship between at-risk foot and all-cause and cardiovascular mortality among the population with diabetes |
| title_fullStr | The relationship between at-risk foot and all-cause and cardiovascular mortality among the population with diabetes |
| title_full_unstemmed | The relationship between at-risk foot and all-cause and cardiovascular mortality among the population with diabetes |
| title_short | The relationship between at-risk foot and all-cause and cardiovascular mortality among the population with diabetes |
| title_sort | relationship between at risk foot and all cause and cardiovascular mortality among the population with diabetes |
| topic | diabetic foot at-risk foot peripheral arterial disease peripheral neuropathy mortality |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1584949/full |
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