Abstract
The aim of the present study was to explore the association between anemia and the risks and outcomes of diabetic foot (DF) in patients with type 2 diabetes mellitus (T2DM). A total of 145 patients with T2DM were recruited between January and December 2021 and divided into the DF and non-DF groups according to whether they were diagnosed with DF. Individual patient data were extracted and blood samples were evaluated in a biochemical center for routine biochemical and blood-related indicators. The patients' survival rates were followed up until December 2022. An independent-samples t-test and χ(2) test were used to compare the differences between the two groups. The association between the various clinical indicators for the DF and non-DF groups was evaluated using single-factor binary logistic regression analysis. Multi-factor binary logistic regression analysis was used to analyze the association between hemoglobin (Hb) and the risk for DF. A Kaplan-Meier survival curve was used to analyze the impact of anemia and DF on the 1-year survival rate. The diabetes duration, number of patients who smoked and consumed alcohol, and serum creatinine and C-reactive protein levels in the DF group were significantly higher than those in the non-DF group (P<0.05). By contrast, the estimated glomerular filtration rate (eGFR) and Hb, albumin (Alb) and total cholesterol levels, were lower in the DF group when compared with those in the non-DF group (P<0.05). All of the study participants were divided into two groups, according to their baseline eGFR [eGFR ≥90 or <90 ml/(min x 1.73 m²)]. It was found that, independently of renal function, lower Hb and Alb levels were associated with a higher incidence of DF. The 1-year survival rate for DF with anemia was significantly lower when compared with that in patients with DF without anemia (P<0.05). In conclusion, the Hb level in patients with T2DM is a protective factor against DF and anemia is an independent risk factor for DF. The present study suggested that anemia is associated with a decrease in the survival rate of patients with DF. This finding provided a theoretical basis for the clinical correction of anemia and improvement of DF prognosis (clinical trial no. 20220003).