{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T17:23:06Z","timestamp":1763400186898,"version":"3.43.0"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["30860113","81560044","82160052"],"award-info":[{"award-number":["30860113","81560044","82160052"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This study aimed to explore the association between metabolic\u2010associated fatty liver disease (MAFLD) and ulcer recurrence risk in patients with diabetic foot ulcers (DFUs) through an ambispective longitudinal cohort. From December 2013 to December 2022, a total of 482 inpatients with DFUs (PEDIS grade 3 and above with a severe infection) were eligible for inclusion in this study. This was an ambispective longitudinal cohort study. All participants were followed up every 6\u2009months for 9\u2009years with a median of 36\u2009months. According to whether having MAFLD or not, all subjects were placed into two groups: non\u2010MAFLD (<jats:italic>n<\/jats:italic>\u2009=\u2009351) and MAFLD (<jats:italic>n<\/jats:italic>\u2009=\u2009131). The association between MAFLD and ulcer recurrence in patients with DFUs was then evaluated through multivariate Cox regression analysis, stratified analyses and Kaplan\u2013Meier survival analysis. Throughout the follow\u2010up period, out of 482 subjects with DFUs, 68 had ulcer recurrence (14.1%). Three Cox regression models were established for data analyses. In the model I (unadjusted), MAFLD was significantly associated with the ulcer recurrence rate in patients with DFUs (HR\u2009=\u20091.79; 95% CI\u2009=\u20091.097\u20132.92; <jats:italic>p<\/jats:italic>\u2009=\u20090.02). Model II (adjusted model I with gender and age) (HR\u2009=\u20091.781; 95% CI\u2009=\u20091.09\u20132.912; <jats:italic>p<\/jats:italic>\u2009=\u20090.021) and model III (adjusted model II with CVD, duration of diabetes and Cr.) (HR\u2009=\u20091.743; 95% CI\u2009=\u20091.065\u20132.855; <jats:italic>p<\/jats:italic>\u2009=\u20090.027) also showed that MAFLD was significantly related to the ulcer recurrence risk in patients with DFUs, respectively. Stratified analysis indicated that subjects aged \u226560 had a greater risk of ulcer recurrence in MAFLD than in non\u2010MAFLD (HR\u2009=\u20092.31; 95% CI\u2009=\u20091.268\u20134.206; <jats:italic>p<\/jats:italic>\u2009=\u20090.006). Kaplan\u2013Meier survival curve analysis showed that ulcer recurrence rate had a significant association with MAFLD (log\u2010rank, <jats:italic>p<\/jats:italic>\u2009=\u20090.018). This study indicated a close association between ulcer recurrence risk and MAFLD in patients with DFUs, especially in the elderly (aged \u226560). Therefore, special attention should be paid to the elderly with both DFUs and MAFLD because they have a higher ulcer recurrence rate than other general populations in routine clinical practice.<\/jats:p>","DOI":"10.1111\/iwj.14586","type":"journal-article","created":{"date-parts":[[2023,12,16]],"date-time":"2023-12-16T02:00:49Z","timestamp":1702692049000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Metabolic dysfunction\u2010associated fatty liver disease in the elderly with diabetic foot ulcers: A longitudinal cohort study"],"prefix":"10.1111","volume":"21","author":[{"given":"Liya","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Endocrinology Shanxi Yingkang Healthcare General Hospital  Yuncheng People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanmei","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism of Guangxi Academy of Medical Sciences People's Hospital of Guangxi Zhuang Autonomous Region  Nanning People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiuxian","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism of Guangxi Academy of Medical Sciences People's Hospital of Guangxi Zhuang Autonomous Region  Nanning People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenwei","family":"Zhai","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism of Guangxi Academy of Medical Sciences People's Hospital of Guangxi Zhuang Autonomous Region  Nanning People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rongyan","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism of Guangxi Academy of Medical Sciences People's Hospital of Guangxi Zhuang Autonomous Region  Nanning People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiacheng","family":"Mo","sequence":"additional","affiliation":[{"name":"Information Network Center of Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region  Nanning People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junjun","family":"Li","sequence":"additional","affiliation":[{"name":"Dean's Office of Guangxi Academy of Medical Sciences People's Hospital of Guangxi Zhuang Autonomous Region  Nanning People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0212-3624","authenticated-orcid":false,"given":"Wensheng","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism of Guangxi Academy of Medical Sciences People's Hospital of Guangxi Zhuang Autonomous Region  Nanning People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.109119"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30058-2"},{"issue":"4","key":"e_1_2_10_4_1","first-page":"807","article-title":"Frequency and risk factors of diabetic retinopathy among patients with type 2 diabetes mellitus: a single\u2010center study from Bangladesh","volume":"29","author":"Rahman MH","year":"2020","journal-title":"Mymensingh Med 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