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
