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Liu M, Zhang W, Yan Z, Yuan X, et al.
Experimental and therapeutic medicine. Date of publication 2018 Feb 1;volume 15(2):1680-1685.
1. Exp Ther Med. 2018 Feb;15(2):1680-1685. doi: 10.3892/etm.2017.5538. Epub 2017 Nov 22. Smoking increases the risk of diabetic foot amputation: A meta-analysis. Liu M(1), Zhang W(2), Yan Z(1), Yuan X(3). Author information: (1)Department of Endocrinology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region 010050, P.R. China. (2)Department of Ophthalmology, Affiliated People's Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region 010020, P.R. China. (3)Health Care Center, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region 010050, P.R. China. Accumulating evidence suggests that smoking is associated with diabetic foot amputation. However, the currently available results are inconsistent and controversial. Therefore, the present study performed a meta-analysis to systematically review the association between smoking and diabetic foot amputation and to investigate the risk factors of diabetic foot amputation. Public databases, including PubMed and Embase, were searched prior to 29th February 2016. The heterogeneity was assessed using the Cochran's Q statistic and the I2 statistic, and odds ratio (OR) and 95% confidence interval (CI) were calculated and pooled appropriately. Sensitivity analysis was performed to evaluate the stability of the results. In addition, Egger's test was applied to assess any potential publication bias. Based on the research, a total of eight studies, including five cohort studies and three case control studies were included. The data indicated that smoking significantly increased the risk of diabetic foot amputation (OR=1.65; 95% CI, 1.09-2.50; P<0.0001) compared with non-smoking. Sensitivity analysis demonstrated that the pooled analysis did not vary substantially following the exclusion of any one study. Additionally, there was no evidence of publication bias (Egger's test, t=0.1378; P=0.8958). Furthermore, no significant difference was observed between the minor and major amputation groups in patients who smoked (OR=0.79; 95% CI, 0.24-2.58). The results of the present meta-analysis suggested that smoking is a notable risk factor for diabetic foot amputation. Smoking cessation appears to reduce the risk of diabetic foot amputation. DOI: 10.3892/etm.2017.5538 PMCID: PMC5774386 PMID: 29434753
Appears in following Topics:
Diabetic Foot Ulcer - Introduction and Assessment