{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:39:28Z","timestamp":1787020768677,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T00:00:00Z","timestamp":1617926400000},"content-version":"vor","delay-in-days":98,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T00:00:00Z","timestamp":1617926400000},"content-version":"vor","delay-in-days":98,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"crossref","award":["18K17897"],"award-info":[{"award-number":["18K17897"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["18\u2009K17897"],"award-info":[{"award-number":["18\u2009K17897"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Journal of Foot and Ankle Research"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The prevalence of diabetes is rising, and diabetes develops at a younger age in East Asia. Although lower limb amputation negatively affects quality of life and increases the risk of cardiovascular events, little is known about the rates and predictors of amputation among persons with diabetes from young adults to those in the \u201cyoung\u2010old\u201d category (50\u201372 y).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from a nationwide claims database in Japan accumulated from 2008 to 2016\u00a0involving 17,288 people with diabetes aged 18\u201372 y (mean age 50.2 y, HbA1c 7.2%). Amputation occurrence was determined according to information from the claims database. Cox regression model identified variables related to lower limb amputation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean follow\u2010up time was 5.3\u2009years, during which time 16\u00a0amputations occurred (0.17\/1000 person\u2010years). Multivariate Cox regression analysis showed that age (hazard ratio [HR] 1.09 [95% confidence intervals] 1.02\u20131.16,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) and HbA1c (HR 1.46 [1.17\u20131.81],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) were independently associated with amputations. Compared with those aged &lt;\u200960\u2009years with HbA1c &lt;\u20098.0%, the HR for amputation was 27.81 (6.54\u2013118.23) in those aged \u226560\u2009years and HbA1c \u22658.0%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Age and HbA1c were associated with amputations among diabetic individuals, and the rates of amputation were significantly greater in those \u226560\u2009years old and with HbA1c \u22658.0%.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13047-021-00474-8","type":"journal-article","created":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T07:03:31Z","timestamp":1617951811000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Rates and risk factors for amputation in people with diabetes in Japan: a historical cohort study using a nationwide claims database"],"prefix":"10.1002","volume":"14","author":[{"given":"Masanori","family":"Kaneko","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Niigata University Faculty of Medicine 1\u2010754 Asahimachi 951\u20108510 Niigata Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6725-4169","authenticated-orcid":false,"given":"Kazuya","family":"Fujihara","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Niigata University Faculty of Medicine 1\u2010754 Asahimachi 951\u20108510 Niigata Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayuko Yamada","family":"Harada","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Niigata University Faculty of Medicine 1\u2010754 Asahimachi 951\u20108510 Niigata Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taeko","family":"Osawa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Niigata University Faculty of Medicine 1\u2010754 Asahimachi 951\u20108510 Niigata Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Niigata University Faculty of Medicine 1\u2010754 Asahimachi 951\u20108510 Niigata Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaru","family":"Kitazawa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Niigata University Faculty of Medicine 1\u2010754 Asahimachi 951\u20108510 Niigata Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Matsubayashi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Niigata University Faculty of Medicine 1\u2010754 Asahimachi 951\u20108510 Niigata Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takaho","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Niigata University Faculty of Medicine 1\u2010754 Asahimachi 951\u20108510 Niigata Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyasu","family":"Seida","sequence":"additional","affiliation":[{"name":"JMDC Inc. Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Kodama","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Niigata University Faculty of Medicine 1\u2010754 Asahimachi 951\u20108510 Niigata Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirohito","family":"Sone","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Niigata University Faculty of Medicine 1\u2010754 Asahimachi 951\u20108510 Niigata Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.12098"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.168099"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14\u20102391"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2017.10.030"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1310799"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.8.1885"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125\u2010011\u20102372\u20105"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102796.1993.tb01003.x"},{"key":"e_1_2_12_10_1","doi-asserted-by":"crossref","unstructured":"MeshkinDH ZolperEG ChangK BryantM BekenyJC EvansKK et al. 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Although members of this organization participated in preparing this manuscript, they did not contribute to the data analysis or the conclusions made. Thus, we feel that this does not represent a potential conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"29"}}