2型糖尿病周围神经病变患者足底动静态压力参数比较及相关因素分析

doi:10.3969/j.issn.1006-5725.2025.04.009

Abstract

Abstract:

Objective To compare plantar dynamic and static pressure parameters between patients with type 2 diabetes mellitus （T2DM） and those with combined diabetic peripheral neuropathy （DPN）， and to analyze associated factors. Methods A retrospective analysis was conducted on 47 cases in the pure T2DM group and 57 cases in the T2DM combined with DPN group. The plantar dynamic and static pressure parameters， along with relevant clinical data， were recorded for each group. Results Age， BMI， cholesterol， and triglycerides were significantly higher in the combined DPN group compared to the T2DM group （P < 0.05）. The average pressure on both feet and the axial angle of the left foot were also significantly greater in the combined DPN group than in the simple T2DM group （P < 0.05）. A larger axial angle suggests an impact on gait or foot function. Additionally， the forefoot loading ratio， hindfoot loading ratio， and medial?lateral loading ratio of the left foot were all significantly higher in the combined DPN group compared to the simple T2DM group （P < 0.05）. For static pressure parameters， no statistically significant differences were observed between the two groups in terms of foot area， load， maximum pressure， or average pressure （P > 0.05）. Spearman's univariate analysis revealed that plantar dynamic and static maximum pressure， mean pressure， and total plantar pressure area were significantly and positively correlated with BMI and triglycerides. Multiple linear regression analysis indicated that the axial angle of the left foot during dynamic pressure was associated with triglyceride levels （P < 0.05）， the load ratio of the left anterior and posterior foot was related to the duration of diabetes mellitus （P < 0.05）， and the bipedal area， maximal pressure， and mean pressure during static pressure were all associated with BMI. Conclusions Dynamic plantar pressure mean compression， left foot axis angle， and loading ratio had a greater influence on foot function in the combined DPN group compared to the T2DM group alone. Regardless of the presence of DPN， attention should be paid to measuring plantar pressure in patients. early intervention using indicators associated with plantar dynamic and static pressures， such as BMI and triglycerides， can provide a clinical reference for preventing diabetic foot complications.

Key words: type 2 diabetes mellitus, peripheral neuropathy, plantar dynamic pressure, plantar static pressure, related factors

CLC Number:

R587.1

Jing WANG,Hui WANG,Yukuan MIAO,Yingqun. NI. Comparison of plantar dynamic and static pressure parameters in patients with type 2 diabetes mellitus combined with diabetic peripheral neuropathy and analysis of related factors[J]. The Journal of Practical Medicine, 2025, 41(4): 522-528.

Figures/Tables 7

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References 27

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项目	单纯T2DM组（n = 47）	DPN组（n = 57）	χ ² /t/Z值	P值
男性/［例（%）］	31（66）	37（64.9）	0.012	0.911
年龄/岁	55.28 ± 12.78	60.32 ± 9.54	2.24	0.028
BMI/（kg/m2）	23.89 ± 3.51	25.36 ± 3.08	2.241	0.027
糖尿病病程［M（P₂₅，P₇₅）］/年	6（2，13）	10（5，12.5）	1.71	0.087
高血压病史/［例（%）］	22（46.8）	26（45.6）	0.015	0.903
FBG/（mmol/L）	8.59 ± 2.60	8.20 ± 2.68	0.76	0.449
2hPBG/（mmol/L）	14.73 ± 4.93	13.72 ± 4.35	1.102	0.273
HbA_1c［M（P₂₅，P₇₅）］/%	8.04（6.93，10.2）	7.80（6.95，9.37）	0.679	0.497
TC/（mmol/L）	4.74 ± 1.12	5.27 ± 1.19	2.311	0.023
TG［M（P₂₅，P₇₅）］/（mmol/L）	1.14（1.11，2.3）	1.50（0.97，1.75）	2.11	0.035

足底动态压力参数	单纯T2DM组（n = 47）	DPN组（n = 57）	t/Z值	P值
最大压强/（gr/cm2）	1 376（1 204，1 508）	1 304（1 194，1 464）	1.839	0.066
平均压强/（gr/cm2）	501（454，546）	565（496，620）	2.544	0.011
足部轴角/°	10（6，15）	14（8，20）	2.138	0.033
压力中心连线增量（x ± s）/mm	199.06 ± 24.31	191.72 ± 25.28	1.500	0.137
前足负荷比（x ± s）/%	61.32 ± 6.32	63.79 ± 5.86	2.050	0.043
后足负荷比（x ± s）/%	36.21 ± 5.86	38.68 ± 6.32	2.050	0.043
负荷比内侧/%	48（44，53）	51（47，55）	2.082	0.037
负荷比外侧/%	49（45.5，53.5）	52（47，56）	2.082	0.037

足底动态压力参数	右足
足底动态压力参数	单纯T2DM组（n = 47）	DPN组（n = 57）	t/Z值	P值
最大压强/（gr/cm2）	1 520（1 230，1 738）	1 424（1 194，1 634）	1.973	0.049
平均压强/（gr/cm2）	540（483.5，629.5）	599（534，652）	2.283	0.022
足部轴角（x ± s）/°	14.40 ± 6.42	15.49 ± 7.81	0.769	0.444
压力中心连线增量（x ± s）/mm	196.51 ± 31.11	192.28 ± 29.56	0.709	0.480
前足负荷比/%	60（54，62）	62（57，65）	1.113	0.266
后足负荷比/%	38（36，44）	40（36.5，44.5）	1.113	0.266
负荷比内侧/%	51（46，57）	53（47，56）	0.648	0.517
负荷比外侧/%	47（44，53）	56（48，63）	0.648	0.517

项目	足底动态压力		足底静态压力
项目	最大压强	平均压强	总面积	最大压强	平均压强
BMI	0.450/< 0.001	0.610/< 0.001	0.422/< 0.001	0.268/0.006	0.380/< 0.001
糖尿病病程	0.012/0.906	-0.029/0.766	-0.044/0.660	-0.002/0.988	-0.088/0.372
高血压病病史	0.057/0.564	0.059/0.551	0.047/0.636	0.073/0.462	0.062/0.532
FBG	-0.068/0.495	-0.050/0.617	0.062/0.532	0.017/0.868	0.049/0.624
2hPBG	-0.003/0.979	-0.003/0.978	-0.026/0.792	0.071/0.474	0.076/0.441
HbA_1c	-0.212/0.031	-0.116/0.239	-0.003/0.977	-0.010/0.919	0.016/0.874
TC	-0.059/0.551	-0.086/0.384	-0.025/0.800	0.075/0.449	0.058/0.556
TG	0.182/0.045	0.325/0.001	0.217/0.027	0.176/0.042	0.195/0.047

项目	足底动态压力		足底静态压力
项目	最大压强	平均压强	总面积	最大压强	平均压强
BMI	0.310/0.048	0.352/< 0.001	0.523/< 0.001	0.194/0.048	0.330/0.001
糖尿病病程	-0.159/0.106	-0.168/0.089	0.022/0.823	-0.100/0.314	-0.112/0.259
高血压病病史	0.018/0.854	0.059/0.549	0.122/0.218	0.014/0.889	-0.001/0.992
FBG	-0.007/0.944	0.094/0.342	-0.033/0.738	0.032/0.745	0.030/0.764
2hPBG	0.069/0.487	0.118/0.233	-0.023/0.815	0.033/0.738	0.064/0.520
HbA_1c	0.002/0.982	0.063/0.523	-0.084/0.396	-0.112/0.257	-0.102/0.305
TC	0.139/0.159	0.124/0.210	-0.132/0.180	0.005/0.962	-0.037/0.708
TG	0.191/0.043	0.269/0.006	0.250/0.010	0.195/0.036	0.158/0.046

Comparison of plantar dynamic and static pressure parameters in patients with type 2 diabetes mellitus combined with diabetic peripheral neuropathy and analysis of related factors

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足底压力		临床资料	β值	b值	R2值	t值	95%CI	P值
动态压力	足部轴角	TG	-0.23	-1.868	0.053	-2.391	-3.418 ~ -0.318	0.019
	前足负荷比	糖尿病病程	-0.25	-0.222	0.077	-2.585	-0.392 ~ -0.052	0.011
		FBG	0.128	0.302	0.077	0.988	-0.305 ~ 0.910	0.326
		2hPBG	0.033	0.044	0.077	0.254	-0.301 ~ 0.389	0.800
	后足负荷比	糖尿病病程	0.25	0.222	0.099	2.607	0.053 ~ 0.392	0.011
		FBG	-0.151	-0.354	0.099	-1.568	-0.803 ~ 0.094	0.120
静态压力	面积	BMI	0.447	2.600	0.184	4.377	1.422 ~ 3.778	< 0.001
		TG	-0.041	-0.753	0.184	-0.402	-4.468 ~ 2.963	0.689
	最大压强	BMI	0.273	9.364	0.074	2.864	2.878 ~ 15.849	0.005
	平均压强	BMI	0.343	5.433	0.138	3.271	2.138 ~ 8.729	0.001

足底压力		临床资料	β值	b值	R2值	t值	95%CI	P值
动态压力	足部轴角	TG	-0.053	-0.356	0.003	-0.541	-1.663 ~ -0.950	0.590
	前足负荷比	糖尿病病程	-0.182	-0.161	0.033	-1.873	-0.331 ~ 0.010	0.064
	后足负荷比	糖尿病病程	0.182	0.161	0.033	1.873	-0.010 ~ 0.331	0.064
静态压力	面积	BMI	0.535	2.894	0.252	5.477	1.846 ~ 3.943	< 0.001
		TG	-0.083	-1.412	0.252	-0.847	-4.717 ~ 1.893	0.399
	最大压强	BMI	0.186	6.763	0.035	1.909	-0.262 ~ 13.789	0.049
	平均压强	BMI	0.353	5.524	0.124	3.804	2.644 ~ 8.404	< 0.001

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