Risk factors for short-term recurrence of diabetic foot ulcer in type 2 diabetes and construction of a nomogram prediction model

Yu Li; Chen Jie; Cui Long; Yin Jingxia; Zheng Lili; Hou Chunyan; Zeng Fang; Li Ling

doi:10.13406/j.cnki.cyxb.004058

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Risk factors for short-term recurrence of diabetic foot ulcer in type 2 diabetes and construction of a nomogram prediction model

Endocrine regulation and metabolic diseases | 更新时间：2026-04-15

- Risk factors for short-term recurrence of diabetic foot ulcer in type 2 diabetes and construction of a nomogram prediction model
- Journal of Chongqing Medical University Vol. 51, Issue 4, Pages: 493-499(2026)
- 作者机构：
  
  1.武警重庆总队医院内分泌科，重庆 400061
  2.武警重庆总队医院护理部，重庆 400061
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.004058
  CLC： R587
- Received：27 November 2025，
  
  Revised：2026-01-20，
  
  Accepted：21 January 2026，
  
  Published：28 April 2026
- 稿件说明：
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余丽，陈洁，崔龙，等.2型糖尿病足短期复发风险因素的分析及预测模型列线图的构建[J].重庆医科大学学报，2026，51（4）：493-499.

Yu Li,Chen Jie,Cui Long,et al.Risk factors for short-term recurrence of diabetic foot ulcer in type 2 diabetes and construction of a nomogram prediction model[J].Journal of Chongqing Medical University,2026,51(4):493-499.
余丽，陈洁，崔龙，等.2型糖尿病足短期复发风险因素的分析及预测模型列线图的构建[J].重庆医科大学学报，2026，51（4）：493-499. DOI： 10.13406/j.cnki.cyxb.004058.

Yu Li,Chen Jie,Cui Long,et al.Risk factors for short-term recurrence of diabetic foot ulcer in type 2 diabetes and construction of a nomogram prediction model[J].Journal of Chongqing Medical University,2026,51(4):493-499. DOI： 10.13406/j.cnki.cyxb.004058.

摘要

目的

探讨2型糖尿病足短期复发风险因素，并构建列线图预测模型。

方法

选择2023年1月1日至2024年6月30日，在本院治疗的120例糖尿病足溃疡（diabetic foot ulcer，DFU）患者，以DFU患者12个月后是否复发分组，即试验组69例DFU患者治疗后复发，对照组51例DFU患者治疗后未复发，比较两组患者的临床资料，采用多因素logistic回归模型分析影响DFU治疗后短期复发的风险因素，基于风险因素构建DFU治疗后短期复发的列线图预测模型，再用受试者工作特征（receiver operating characteristic，ROC）曲线与校准曲线模型验证预测价值。

结果

试验组与对照组在性别、教育背景、病程、合并高血压、吸烟史、饮酒史、合并糖尿病肾病、合并糖尿病神经病、溃疡部位、血管病变比较差异均有统计学意义（

0.05）。多因素logistic回归分析结果显示，病程、吸烟史、饮酒史、合并糖尿病周围神经病变为DFU治疗后短期复发的独立因素［比值比（odds ratio，OR）

1］。创建的列线图预测模型校正曲线与理想曲线贴合度较好，提示列线图模型具有较高的预测准确度；ROC曲线下面积为0.966，提示列线图模型具有较高的预测价值。

结论

病程、吸烟史、饮酒史、合并糖尿病周围神经病变为2型糖尿病足短期复发独立风险因素。基于以上4项影响因素构建的列线图模型对预测DFU治疗后短期复发具有较高预测价值。

Abstract

Objective

To investigate the risk factors for short-term recurrence of diabetic foot ulcer （DFU） in type 2 diabetes，and to construct a nomogram prediction model.

Methods

A total of 120 patients with DFU who were treated in our hospital from January 1，2023 to June 30，2024 were enrolled，and according to the presence or absence of recurrence at 12 months after treatment，the patients were divided into experimental group（69 patients with recurrence after treatment） and control group （51 patients without recurrence after treatment）. Clinical data were compared between the two groups. The multivariate logistic regression analysis was used to investigate the risk factors for short-term recurrence，and a nomogram prediction model was developed based on these factors for predicting the short-term recurrence of DFU after treatment. The receiver operating characteristic （ROC） curve and the calibration curve were used to assess the predictive value of the model.

Results

There were significant differences between the experimental group and the control group in sex，educational background，disease duration，hypertension，smoking history，alcohol consumption history，concurrent diabetic nephropathy，concurrent diabetic neuropathy，ulcer site，and vascular lesions（

0.05）. The multivariate logistic regression analysis showed that disease duration，smoking history，alcohol consumption history，and concurrent diabetic peripheral neuropathy were independent factors for short-term recurrence of DFU after treatment（odds ratio

1）. The calibration curve of the nomogram prediction model fit well with the ideal curve，indicating that the nomogram model had high predictive accuracy，and the model had an area under the ROC curve of 0.966，suggesting that it had high predictive value.

Conclusion

Disease duration，smoking history，alcohol consumption history，and concurrent diabetic peripheral neuropathy are independent risk factors for short-term recurrence of type 2 diabetic foot. The nomogram model constructed based on these four factors has a relatively high value in predicting short-term recurrence of DFU after treatment.

关键词

Keywords

references

Sun H ， Saeedi P ， Karuranga S ， et al ． IDF Diabetes Atlas： Global，regional and country-level diabetes prevalence estimates for 2021 and projections for 2045 [J ] . Diabetes Res Clin Pract ， 2022 ， 183 ： 109119 ．

Bellomo TR ， Lee S ， McCarthy M ， et al . Management of the diabetic foot [J ] . Semin Vasc Surg ， 2022 ， 35 （ 2 ）： 219 - 227 ．

Guo QJ ， Ying G ， Ouyang J ， et al . Influencing factors for the recurrence of diabetic foot ulcers： A meta-analysis [J ] . Int Wound J ， 2023 ， 20 （ 5 ）： 1762 - 1775 ．

吴晨葳，张书评，边红艳 . 糖尿病足患者生存质量现状及其影响因素 [J ] . 中国卫生工程学， 2023 ， 22 （ 4 ）： 489 - 491 ．

Wu CW ， Zhang SP ， Bian HY . Current status of quality of life and its influencing factors in patients with diabetic foot [J ] . Chin J Public Health Eng ， 2023 ， 22 （ 4 ）： 489 - 491 ．

任明容，汪　义，张　勇，等 . 158例糖尿病足流行病学及相关危险因素分析 [J ] . 临床医学， 2019 ， 39 （ 10 ）： 4 - 6 ．

Ren MR ， Wang Y ， Zhang Y ， et al . Epidemiology of 158 cases of diabetic foot and analysis of related risk factors [J ] . Clin Med ， 2019 ， 39 （ 10 ）： 4 - 6 ．

龚洪平，任　妍，查盼盼，等 . 初发与复发性糖尿病足溃疡临床特征分析 [J ] . 四川大学学报（医学版）， 2022 ， 53 （ 6 ）： 969 - 975 ．

Gong HP ， Ren Y ， Zha PP ， et al . Clinical characteristics of diabetic patients with initial and recurrent foot ulcers [J ] . J Sichuan Univ Med Sci ， 2022 ， 53 （ 6 ）： 969 - 975 ．

谢晓玲 . 糖尿病足溃疡创面伤口愈后复发的影响因素分析 [J ] . 护理实践与研究， 2020 ， 17 （ 15 ）： 23 - 25 ．

Xie XL . Analysis of factors affecting the recurrence of diabetic foot ulcers wounds after wound healing [J ] . Nurs Pract Res ， 2020 ， 17 （ 15 ）： 23 - 25 ．

Ogurtsova K ， Morbach S ， Haastert B ， et al . Cumulative long-term recurrence of diabetic foot ulcers in two cohorts from centres in Germany and the Czech Republic [J ] . Diabetes Res Clin Pract ， 2021 ， 172 ： 108621 ．

李金金 . 天津市慢性病队列研究及风险预测模型的建立 [D ] . 天津：天津医科大学， 2018 ．

Li JJ . The Tianjin cohort study of non-communicable diseases and establishing prediction models [D ] . Tianjin ： Tianjin Medical University ， 2018 ．

康艳楠 . 糖尿病足复发的影响因素与风险预测模型研究 [D ] . 天津：天津中医药大学， 2022 ．

Kang YN . Study on the influence factors and risk prediction model of diabetic foot recurrence [D ] . Tianjin ： Tianjin University of Traditional Chinese Medicine ， 2022 ．

Wang MJ ， Chen D ， Fu HM ， et al . Development and validation of a risk prediction model for the recurrence of foot ulcer in type 2 diabetes in China： A longitudinal cohort study based on a systematic review and meta-analysis [J ] . Diabetes Metab Res Rev ， 2023 ， 39 （ 4 ）： e3616 ．

Bianchi L ， Castellucci P ， Farolfi A ， et al . Multicenter external validation of a nomogram for predicting positive prostate-specific membrane antigen/positron emission tomography scan in patients with prostate cancer recurrence [J ] . Eur Urol Oncol ， 2023 ， 6 （ 1 ）： 41 - 48 ．

He YZ ， Luo LH ， Shan RF ， et al . Development and validation of a nomogram for predicting postoperative early relapse and survival in hepatocellular carcinoma [J ] . J Natl Compr Canc Netw ， 2023 ， 22 （ 1D ）： e237069 ．

Stevelink R ， Al-Toma D ， Jansen FE ， et al . Individualised prediction of drug resistance and seizure recurrence after medication withdrawal in people with juvenile myoclonic epilepsy： A systematic review and individual participant data meta-analysis [J ] . EClinicalMedicine ， 2022 ， 53 ： 101732 ．

张会峰，许樟荣，冉兴无 . 糖尿病足的相关定义和标准 [J ] . 中华糖尿病杂志， 2020 ， 12 （ 6 ）： 363 - 368 ．

Zhang HF ， Xu ZR ， Ran XW . Definition and standards of diabetic foot [J ] . Chin J Diabetes Mellit ， 2020 ， 12 （ 6 ）： 363 - 368 ．

杨　帆，徐子辉，赵　玉，等 . 基于糖尿病专病数据库构建糖尿病足溃疡预测模型 [J ] . 中华糖尿病杂志， 2025 ， 17 （ 7 ）： 824 - 829 ．

Yang F ， Xu ZH ， Zhao Y ， et al . Prediction model for diabetic foot ulcer based on a diabetes database [J ] . Chin J Diabetes Mellit ， 2025 ， 17 （ 7 ）： 824 - 829 ．

van Netten JJ ， Bus SA ， Apelqvist J ， et al . Definitions and criteria for diabetes-related foot disease（IWGDF 2023 update） [J ] . Diabetes Metab Res Rev ， 2024 ， 40 （ 3 ）： e3654 ．

Hu L ， Liu WJ ， Yin LQ ， et al . Analysis of factors influencing the recurrence of diabetic foot ulcers [J ] . Skin Res Technol ， 2024 ， 30 （ 7 ）： e13826 ．

Aan de Stegge WB ， Schut MC ， Abu-Hanna A ， et al . Development of a prediction model for foot ulcer recurrence in people with diabetes using easy-to-obtain clinical variables [J ] . BMJ Open Diabetes Res Care ， 2021 ， 9 （ 1 ）： e002257 ．

McDermott K ， Fang M ， Boulton AJM ， et al . Etiology，epidemiology，and disparities in the burden of diabetic foot ulcers [J ] . Diabetes Care ， 2023 ， 46 （ 1 ）： 209 - 221 ．

Bechara N ， Hng TM ， Gunton JE . The association between tobacco smoking and systolic toe pressures in active foot ulceration [J ] . Sci Rep ， 2024 ， 14 （ 1 ）： 8550 ．

Guo PP ， Tu YJ ， Liu RY ， et al . Performance of risk prediction models for diabetic foot ulcer： a meta-analysis [J ] . PeerJ ， 2024 ， 12 ： e17770 ．

Lee YJ ， Han KD ， Kim JH . Association among current smoking，alcohol consumption，regular exercise，and lower extremity amputation in patients with diabetic foot： nationwide population-based study [J ] . Endocrinol Metab ， 2022 ， 37 （ 5 ）： 770 - 780 ．

王弘妍，郝　伟，王　敏，等 . 国际糖尿病足工作组《糖尿病足溃疡减压治疗指南（2023版）》的解读与应用 [J ] . 中华糖尿病杂志， 2024 ， 16 （ 7 ）： 823 - 826 ．

Wang HY ， Hao W ， Wang M ， et al . Interpretation and application of the International Working Group on the Diabetic Foot′s Guidelines on offloading foot ulcers in persons with diabetes （2023 update） [J ] . Chin J Diabetes Mellit ， 2024 ， 16 （ 7 ）： 823 - 826 ．

Senneville É ， Albalawi Z ， van Asten SA ， et al . IWGDF/IDSA guidelines on the diagnosis and treatment of diabetes-related foot infections （IWGDF/IDSA 2023） [J ] . Clin Infect Dis ， 2023 ：ciad527．

Chen H ， Mei SS ， Zhou Y ， et al . Systematic review and meta-analysis of the diagnostic accuracy of inflammatory markers for infected diabetic foot ulcer [J ] . J Tissue Viability ， 2024 ， 33 （ 4 ）： 598 - 607 ．

Sen CK ， Gordillo GM ， Roy S ， et al . High transepidermal water loss at the site of wound closure is associated with increased recurrence of diabetic foot ulcers： the NIDDK diabetic foot consortium TEWL study [J ] . Diabetes Care ， 2025 ， 48 （ 7 ）： 1233 - 1240 ．

李　萍，谢　爽，徐方艳 . 2型糖尿病足患者凝血指标检测及与病变的相关性分析 [J ] . 中华内分泌外科杂志， 2023 ， 17 （ 3 ）： 337 - 341 .

Li P ， Xie S ， Xu FY . Detection of coagulation indicators in patients with type 2 diabetic foot and analysis of their correlation with lesions [J ] . Chin J Endocr Surg ， 2023 ， 17 （ 3 ）： 337 - 341 .

Kim JW ， Han KD ， Kim JH ， et al . Protective effect of regular physical activity against diabetes-related lower extremity amputation [J ] . J Diabetes ， 2024 ， 16 （ 10 ）： e70011 ．

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