The association between micronutrient levels and diabetic foot ulcer: A systematic review with meta-analysis
BackgroundDiabetic foot ulcers (DFU) are a major complication of diabetes mellitus (DM). Nutrient deficiencies are among the major risk factors in DFU development and healing. In this context, we aimed to investigate the possible association between micronutrient status and risk of DFU.MethodsA syst...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1152854/full |
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| author | Shilia Jacob Kurian Shilia Jacob Kurian Tejaswini Baral Tejaswini Baral Mazhuvancherry K. Unnikrishnan Ruby Benson Murali Munisamy Kavitha Saravu Kavitha Saravu Gabriel Sunil Rodrigues Mahadev Rao Amit Kumar Sonal Sekhar Miraj Sonal Sekhar Miraj |
| author_facet | Shilia Jacob Kurian Shilia Jacob Kurian Tejaswini Baral Tejaswini Baral Mazhuvancherry K. Unnikrishnan Ruby Benson Murali Munisamy Kavitha Saravu Kavitha Saravu Gabriel Sunil Rodrigues Mahadev Rao Amit Kumar Sonal Sekhar Miraj Sonal Sekhar Miraj |
| author_sort | Shilia Jacob Kurian |
| collection | DOAJ |
| description | BackgroundDiabetic foot ulcers (DFU) are a major complication of diabetes mellitus (DM). Nutrient deficiencies are among the major risk factors in DFU development and healing. In this context, we aimed to investigate the possible association between micronutrient status and risk of DFU.MethodsA systematic review (Prospero registration: CRD42021259817) of articles, published in PubMed, Web of Science, Scopus, CINAHL Complete, and Embase, that measured the status of micronutrients in DFU patients was performed.ResultsThirty-seven studies were considered, of which thirty were included for meta-analysis. These studies reported levels of 11 micronutrients: vitamins B9, B12, C, D, E, calcium, magnesium, iron, selenium, copper, and zinc. DFU, compared to healthy controls (HC) had significantly lower vitamin D (MD: -10.82 14 ng/ml, 95% CI: -20.47, -1.16), magnesium (MD: -0.45 mg/dL, 95% CI: -0.78, -0.12) and selenium (MD: -0.33 µmol/L, 95% CI: -0.34, -0.32) levels. DFU, compared to DM patients without DFU, had significantly lower vitamin D (MD: -5.41 ng/ml, 95% CI: -8.06, -2.76), and magnesium (MD: -0.20 mg/dL, 95% CI: -0.25, -0.15) levels. The overall analysis showed lower levels of vitamin D [15.55ng/ml (95% CI:13.44, 17.65)], vitamin C [4.99µmol/L (95% CI:3.16, 6.83)], magnesium [1.53mg/dL (95% CI:1.28, 1.78)] and selenium [0.54µmol/L (95% CI:0.45, 0.64)].ConclusionThis review provides evidence that micronutrient levels significantly differ in DFU patients, suggesting an association between micronutrient status and risk of DFU. Therefore, routine monitoring and supplementations are warranted in DFU patients. We suggest that personalized nutrition therapy may be considered in the DFU management guidelines.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=259817, identifier CRD42021259817. |
| first_indexed | 2024-04-09T21:04:32Z |
| format | Article |
| id | doaj.art-dadc912a4ced4ca48086a352881b7374 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-09T21:04:32Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-dadc912a4ced4ca48086a352881b73742023-03-29T05:17:46ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-03-011410.3389/fendo.2023.11528541152854The association between micronutrient levels and diabetic foot ulcer: A systematic review with meta-analysisShilia Jacob Kurian0Shilia Jacob Kurian1Tejaswini Baral2Tejaswini Baral3Mazhuvancherry K. Unnikrishnan4Ruby Benson5Murali Munisamy6Kavitha Saravu7Kavitha Saravu8Gabriel Sunil Rodrigues9Mahadev Rao10Amit Kumar11Sonal Sekhar Miraj12Sonal Sekhar Miraj13Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of High Education, Manipal, Karnataka, IndiaManipal Centre for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, IndiaDepartment of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of High Education, Manipal, Karnataka, IndiaManipal Centre for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, IndiaNGSM Institute of Pharmaceutical Sciences, NITTE (Deemed to be University), Mangalore, Karnataka, IndiaDepartment of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of High Education, Manipal, Karnataka, IndiaDepartment of Translational Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, IndiaManipal Centre for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, IndiaDepartment of Infectious Diseases, Kasturba Medical College and Hospital, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, IndiaDepartment of General & Laparoscopic Surgery, Aster Al Raffah Hospital, Sohar, OmanDepartment of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of High Education, Manipal, Karnataka, IndiaDepartment of Laboratory Medicine, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, IndiaDepartment of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of High Education, Manipal, Karnataka, IndiaManipal Centre for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, IndiaBackgroundDiabetic foot ulcers (DFU) are a major complication of diabetes mellitus (DM). Nutrient deficiencies are among the major risk factors in DFU development and healing. In this context, we aimed to investigate the possible association between micronutrient status and risk of DFU.MethodsA systematic review (Prospero registration: CRD42021259817) of articles, published in PubMed, Web of Science, Scopus, CINAHL Complete, and Embase, that measured the status of micronutrients in DFU patients was performed.ResultsThirty-seven studies were considered, of which thirty were included for meta-analysis. These studies reported levels of 11 micronutrients: vitamins B9, B12, C, D, E, calcium, magnesium, iron, selenium, copper, and zinc. DFU, compared to healthy controls (HC) had significantly lower vitamin D (MD: -10.82 14 ng/ml, 95% CI: -20.47, -1.16), magnesium (MD: -0.45 mg/dL, 95% CI: -0.78, -0.12) and selenium (MD: -0.33 µmol/L, 95% CI: -0.34, -0.32) levels. DFU, compared to DM patients without DFU, had significantly lower vitamin D (MD: -5.41 ng/ml, 95% CI: -8.06, -2.76), and magnesium (MD: -0.20 mg/dL, 95% CI: -0.25, -0.15) levels. The overall analysis showed lower levels of vitamin D [15.55ng/ml (95% CI:13.44, 17.65)], vitamin C [4.99µmol/L (95% CI:3.16, 6.83)], magnesium [1.53mg/dL (95% CI:1.28, 1.78)] and selenium [0.54µmol/L (95% CI:0.45, 0.64)].ConclusionThis review provides evidence that micronutrient levels significantly differ in DFU patients, suggesting an association between micronutrient status and risk of DFU. Therefore, routine monitoring and supplementations are warranted in DFU patients. We suggest that personalized nutrition therapy may be considered in the DFU management guidelines.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=259817, identifier CRD42021259817.https://www.frontiersin.org/articles/10.3389/fendo.2023.1152854/fulldiabetic foot ulcersmicronutrientsvitaminsmineralsrisk |
| spellingShingle | Shilia Jacob Kurian Shilia Jacob Kurian Tejaswini Baral Tejaswini Baral Mazhuvancherry K. Unnikrishnan Ruby Benson Murali Munisamy Kavitha Saravu Kavitha Saravu Gabriel Sunil Rodrigues Mahadev Rao Amit Kumar Sonal Sekhar Miraj Sonal Sekhar Miraj The association between micronutrient levels and diabetic foot ulcer: A systematic review with meta-analysis Frontiers in Endocrinology diabetic foot ulcers micronutrients vitamins minerals risk |
| title | The association between micronutrient levels and diabetic foot ulcer: A systematic review with meta-analysis |
| title_full | The association between micronutrient levels and diabetic foot ulcer: A systematic review with meta-analysis |
| title_fullStr | The association between micronutrient levels and diabetic foot ulcer: A systematic review with meta-analysis |
| title_full_unstemmed | The association between micronutrient levels and diabetic foot ulcer: A systematic review with meta-analysis |
| title_short | The association between micronutrient levels and diabetic foot ulcer: A systematic review with meta-analysis |
| title_sort | association between micronutrient levels and diabetic foot ulcer a systematic review with meta analysis |
| topic | diabetic foot ulcers micronutrients vitamins minerals risk |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1152854/full |
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