Risk factors for Charcot foot

Nóbrega, Marta Barreto de Medeiros; Aras, Roque; Netto, Eduardo Martins; Couto, Ricardo David; Marinho, Alexandre; Silva, João Luís da; Colares, Víctor Nóbrega Quintas; Campelo, Priscilla Leite; Nunes, Marcos André Lima

doi:10.1590/2359-3997000000042

Cited by 23 publications

(18 citation statements)

References 26 publications

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“…Additionally, the increased blood flow may directly cause increased bone resorption by increasing the delivery of osteoclasts and monocytes resulting in greater osteoclastic activity in this area [ 15 ]. This is consistent with the finding that patients with a Charcot foot show increased blood flow to the area whereas patients with peripheral arterial disease and diabetes are relatively protected from developing the arthropathy [ 16 , 17 ].…”

Section: Pathogenesissupporting

confidence: 89%

“…Other studies report the most patients with DNOAP in their sixth and seventh decades [ 2 , 52 ]. Fauzi et al [ 16 ] and Nobrega et al [ 17 ] reported that age below 60 and 55 years were significant risk factors for DNOAP respectively.…”

Section: Relative Risk Factorsmentioning

confidence: 99%

“…Compared with patients with diabetic foot ulceration, the patients with DNOAP were less likely to have peripheral arterial disease, ischemia, or the need for revascularization [ 63 ]. Nobrega et al [ 17 ] also reported that peripheral arterial disease was a protective factor to DNOAP.…”

Section: Relative Risk Factorsmentioning

confidence: 99%

“…Other potential relative risk factors reported in the literature including increased levels of HbA1c in serum, treatment with insulin/insulin and oral hypoglycemic agents, retinopathy, prolonged walking, living alone, and low literate education [ 16 , 17 , 22 , 54 , 66 , 68 ].…”

Section: Relative Risk Factorsmentioning

confidence: 99%

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Pathogenesis and potential relative risk factors of diabetic neuropathic osteoarthropathy

et al. 2017

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Diabetic neuropathic osteoarthropathy (DNOAP) is an uncommon, but with considerable morbidity and mortality rates, complication of diabetes. The real pathogenesis is still unclear. The two popular theories are the neuro-vascular theory and neuro-traumatic theory. Most theories and pathways focused on the uncontrolled inflammations that resulted in the final common pathway, receptor activator of nuclear factor κβ ligand (RANKL)/osteoprotegerin (OPG) axis, for the decreased bone density in DNOAP with an osteoclast and osteoblast imbalance. However, the RANKL/OPG pathway does not explain all the changes, other pathways and factors also play roles. A lot of DNOAP potential relative risk factors were evaluated and reported in the literature, including age, gender, weight, duration and type of diabetes, bone mineral density, peripheral neuropathy and arterial disease, trauma history, and some others. However, most of them are still in debates. Future studies focus on the pathogenesis of DNOAP are still needed, especially for the genetic factors. And, the relationship between DNOAP and those potential relative risk factors are still need to further clarify.

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Section: Pathogenesissupporting

confidence: 89%

Section: Relative Risk Factorsmentioning

confidence: 99%

Section: Relative Risk Factorsmentioning

confidence: 99%

Section: Relative Risk Factorsmentioning

confidence: 99%

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Pathogenesis and potential relative risk factors of diabetic neuropathic osteoarthropathy

et al. 2017

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“…Charcot foot (CF) disease is a rare (0.08–7.5%) but extremely debilitating complication in patients with diabetes 1 , which can result in amputation and increased mortality 2 . Indeed the life expectancy of patients with CF is reduced by ~14.4 years 3 .…”

Section: Introductionmentioning

confidence: 99%

Circulating microparticles in acute diabetic Charcot foot exhibit a high content of inflammatory cytokines, and support monocyte-to-osteoclast cell induction

Pasquier

Thomas

Hoarau-Véchot

et al. 2017

Sci Rep

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Circulating microparticles (MPs) are major mediators in cardiovascular complications of type 2 diabetes (T2D); however, their contribution to Charcot foot (CF) disease is not known. Here, we purified and assessed the origin, concentration and content of circulating MPs from 33 individuals: 11 with T2D and acute CF, 11 T2D patients with equivalent neuropathy and 11 non-diabetic controls. First, we demonstrated that there were no differences in the distribution of MPs of endothelial, platelet origin among the 3 groups. However, MPs from leukocytes and monocytes origin were increased in CF patients. Moreover, we demonstrated that monocytes-derived MPs originated more frequently from intermediate and non-classical monocytes in CF patients. Five cytokines (G-CSF, GM-CSF, IL-1-ra, IL-2 and IL-16) were significantly increased in MPs from acute CF patients. Applying ingenuity pathways analysis, we found that those cytokines interacted well and induced the activation of pathways that are involved in osteoclast formation. Further, we treated THP-1 monocytes and monocytes sorted from healthy patients with CF-derived MPs during their differentiation into osteoclasts, which increased their differentiation into multinucleated osteoclast-like cells. Altogether, our study suggests that circulating MPs in CF disease have a high content of inflammatory cytokines and could increase osteoclast differentiation in vitro.

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Contralateral foot temperature monitoring during Charcot immobilisation: A systematic review

Jones

Davies

Webb

et al. 2023

Diabetes Metabolism Res

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Aims: Contralateral temperature difference (CTD) is a frequently used marker of healing in Charcot neuro-osteoarthropathy (CN). We aimed to determine whether there is a consistent approach to CTD measurement during healing and the decision-making process around cessation of immobilisation.Materials and Methods: Medline, Scopus, and Web of Science were searched until February 2022 for peer-reviewed studies using keywords, including (('arthropathy' OR 'osteoarthropathy' OR 'osteopathy' OR 'neuroarthropathy') AND 'Charcot' AND ('temperature')), which returned 789 results excluding duplicates. Included studies monitored CTD in those with active CN to (i) assess the healing process and (ii) assist in determining the transition from immobilisation.Results: Thirty four studies in total (n = 677 participants) were shortlisted and 19 were included after full paper review. Average CTD at presentation varied from 1.6 to 8.0°C with insufficient data to determine if CTD was proportional to severity of Charcot. Evidence of a relationship between CTD and radiographic or scintigraphybased markers of healing varied depending on the methodology employed.Threshold CTD for the cessation of immobilisation ranged from <1°C to <2°C. Most frequently it was <2°C sustained for 2-3 visits. Temperature was monitored typically every 2-6 weeks using handheld thermometry at CN site(s) after resting the feet for 15 min. Device type, accuracy/reliability, and ambient temperature were rarely reported.Conclusions: Further research on CTD and radiographic and radiotracer markers is needed involving larger cohorts. Standardisation in reporting of thermometry device type, accuracy and reliability, foot resting times, and ambient temperature controls is essential to facilitate the comparison of studies, meta-analysis, and evaluation of different immobilisation interventions.

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Risk factors for Charcot foot

Cited by 23 publications

References 26 publications

Pathogenesis and potential relative risk factors of diabetic neuropathic osteoarthropathy

Pathogenesis and potential relative risk factors of diabetic neuropathic osteoarthropathy

Circulating microparticles in acute diabetic Charcot foot exhibit a high content of inflammatory cytokines, and support monocyte-to-osteoclast cell induction

Contralateral foot temperature monitoring during Charcot immobilisation: A systematic review

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