Abstract
BACKGROUND: This study aimed to investigate the relationship between serum osmolality and diabetic foot ulcers (DFUs). METHODS: We used data from the US National Health and Nutrition Examination Survey (NHANES) from 1999 to 2004. The association of each variable with DFU was explored. A multivariate logistic regression model was used to test the relationship between serum osmolality and DFU. In addition, we performed subgroup analyses to assess the reliability of the results. RESULTS: Serum osmolality was significantly associated with DFU (p value < 0.05). Multivariate logistic regression analysis showed a significant association between serum osmolality and DFU (OR = 1.04, 95% CI: 1.01-1.07). Participants in the higher osmolality group (281-312 mOsm/kg) had 2.14 times higher DFU prevalence than those in the lower group (245-280 mOsm/kg) (OR = 2.14, 95% CI: 1.29-3.55). In addition, subgroup analyses and cross-examinations confirmed that gender, age, and other variables did not significantly alter this association (all p values > 0.05). CONCLUSIONS: We found that higher serum osmolality was associated with increased DFU odds. Close monitoring of serum osmolality levels in populations at high risk of DFU may facilitate early identification of the occurrence of DFU.