{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:59:56Z","timestamp":1761897596246,"version":"build-2065373602"},"reference-count":21,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T00:00:00Z","timestamp":1630368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2018R1C15042849","2018R1C15042849 -> No. 2021R1C1C1013218"],"award-info":[{"award-number":["2018R1C15042849","2018R1C15042849 -> No. 2021R1C1C1013218"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The evidence for the association between diurnal temperature range (DTR) and diabetic foot amputations is limited. We aimed to investigate the region-specific association between DTR and the amputation rate of diabetic foot in Korean national-wide data. Daily data on DTR and the rate of diabetic foot amputations from 16 provincial capital cities in Korea were obtained (2011\u20132018). In this study, the latitude ranged from 33\u00b011\u2032 N to 38\u00b061\u2032 N, and we classified each region according to latitude. Region 1, which was located at a relatively high latitude, included Seoul, Incheon, Gyeonggi-do, and Gangwon-do. Region 2, which was located at a relatively low latitude, included Busan, Ulsan, Gyeonsannam-do, Gwangju, Jeollanam-do, Jeollabuk-do, and Jeju-do. The region-specific DTR effects on the amputation rate were estimated based on a quasi-Poisson generalized linear model, combined with a distributed lag non-linear model based on the self-controlled case series design. The DTR impacts were generally limited to a period of nine days, while significant effects during lag days 7\u201314 were only found in the cities of Seoul, Incheon, and Gyeonggi-do (10th lag day: RR [95% CI]; Seoul: 1.015, [1.001\u20131.029]; Incheon: 1.052 [1.006\u20131.101]; Gyeonggi-do: 1.018 [1.002\u20131.034]). In the subgroup analysis (according to the latitude), an increase of 1 \u00b0C in DTR was associated with the risk of diabetic foot in relatively high latitude regions. DTR has considerable effects on the risk of diabetic foot amputation in various provinces in Korea, and it was particularly affected by latitude. The results can inform the decisions on developing programs to protect vulnerable subpopulations from adverse impacts.<\/jats:p>","DOI":"10.3390\/ijerph18179191","type":"journal-article","created":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T08:42:32Z","timestamp":1630399352000},"page":"9191","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Diurnal Temperature Ranges in Relation to Lower Limb Amputation Rate of Diabetic Foot in South Korea: A Population Based Nationwide Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5471-7432","authenticated-orcid":false,"given":"Sung Hun","family":"Won","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Soon Chun Hyang University Seoul Hospital, Seoul 04401, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyung-Jin","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Inje University Sanggye Paik Hospital, Seoul 01757, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7313-5227","authenticated-orcid":false,"given":"Jinyoung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Statistics, Chung-Ang University, Seoul 06974, Korea"},{"name":"RexSoft Corps, Seoul 08826, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ye Jin","family":"Jeon","sequence":"additional","affiliation":[{"name":"RexSoft Corps, Seoul 08826, Korea"},{"name":"Department of Public Health, Yonsei University Graduate School, Seoul 03722, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7255-8984","authenticated-orcid":false,"given":"Dong-Il","family":"Chun","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Soon Chun Hyang University Seoul Hospital, Seoul 04401, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tae-Hong","family":"Min","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Soon Chun Hyang University Seoul Hospital, Seoul 04401, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8680-4680","authenticated-orcid":false,"given":"Jaeho","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon 24253, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sungho","family":"Won","sequence":"additional","affiliation":[{"name":"RexSoft Corps, Seoul 08826, Korea"},{"name":"Graduate School of Public Health, Seoul National University, Seoul 08826, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5022-4251","authenticated-orcid":false,"given":"Young","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Inje University Seoul Paik Hospital, Seoul 04551, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1136\/bmj.289.6456.1405","article-title":"Increases in platelet and red cell counts, blood viscosity, and arterial pressure during mild surface cooling: Factors in mortality from coronary and cerebral thrombosis in winter","volume":"289","author":"Keatinge","year":"1984","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Chun, D.-I., Kim, S., Kim, J., Yang, H.-J., Kim, J.H., Cho, J.-H., Yi, Y., Kim, W.J., and Won, S.H. (2019). Epidemiology and Burden of Diabetic Foot Ulcer and Peripheral Arterial Disease in Korea. J. Clin. Med., 8.","DOI":"10.3390\/jcm8050748"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"345","DOI":"10.7547\/17-131","article-title":"Temperature as a Causative Factor in Diabetic Foot Ulcers: A Call to Revisit Ulceration Pathomechanics","volume":"109","author":"Yavuz","year":"2019","journal-title":"J. Am. Podiatr. Med. Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"14","DOI":"10.2337\/dc06-1600","article-title":"Preventing Diabetic Foot Ulcer Recurrence in High-Risk Patients: Use of temperature monitoring as a self-assessment tool","volume":"30","author":"Lavery","year":"2007","journal-title":"Diabetes Care"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"142","DOI":"10.14193\/jkfas.2020.24.4.142","article-title":"Relationship between the Diurnal Temperature Range and Wound Healing of Diabetic Foot: Animal Study","volume":"24","author":"Won","year":"2020","journal-title":"J. Korean Foot Ankle Soc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/s00484-008-0187-y","article-title":"Diurnal temperature range and emergency room admissions for chronic obstructive pulmonary disease in Taiwan","volume":"53","author":"Liang","year":"2009","journal-title":"Int. J. Biometeorol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1177\/147323000803600626","article-title":"Plasma Ghrelin Levels and Weight Loss in Chinese Uygur Patients with Chronic Obstructive Pulmonary Disease","volume":"36","author":"Ying","year":"2008","journal-title":"J. Int. Med. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/j.ijcard.2006.03.067","article-title":"Is diurnal temperature range a risk factor for acute stroke death?","volume":"116","author":"Chen","year":"2007","journal-title":"Int. J. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1016\/j.jstrokecerebrovasdis.2016.02.037","article-title":"Average Temperature, Diurnal Temperature Variation, and Stroke Hospitalizations","volume":"25","author":"Lichtman","year":"2016","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.scitotenv.2011.12.048","article-title":"Effects of diurnal temperature range on cardiovascular and respiratory hospital admissions in Korea","volume":"417\u2013418","author":"Lim","year":"2012","journal-title":"Sci. Total Environ."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Tian, Y., Liu, H., Si, Y., Cao, Y., Song, J., Li, M., Wu, Y., Wang, X., Xiang, X., and Juan, J. (2019). Association between temperature variability and daily hospital admissions for cause-specific cardiovascular disease in urban China: A national time-series study. PLoS Med., 16.","DOI":"10.1371\/journal.pmed.1002738"},{"key":"ref_12","first-page":"222","article-title":"Association between diurnal temperature range and respiratory tract infections","volume":"26","author":"Ge","year":"2013","journal-title":"Biomed. Environ. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/irv.12682","article-title":"Effects of temperature, humidity, and diurnal temperature range on influenza incidence in a temperate region","volume":"14","author":"Park","year":"2020","journal-title":"Influenza Other Respir. Viruses"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Zheng, S., Zhu, W., Wang, M., Shi, Q., Luo, Y., Miao, Q., Nie, Y., Kang, F., Mi, X., and Bai, Y. (2020). The effect of diurnal temperature range on blood pressure among 46,609 people in Northwestern China. Sci. Total Environ., 730.","DOI":"10.1016\/j.scitotenv.2020.138987"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1177\/0022034509359125","article-title":"Factors Affecting Wound Healing","volume":"89","author":"Guo","year":"2010","journal-title":"J. Dent. Res."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Lee, W.-H., Lim, Y.-H., Dang, T.N., Seposo, X., Honda, Y., Guo, Y.-L.L., Jang, H.-M., and Kim, H. (2017). An Investigation on Attributes of Ambient Temperature and Diurnal Temperature Range on Mortality in Five East-Asian Countries. Sci. Rep., 7.","DOI":"10.1038\/s41598-017-10433-8"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1002\/bimj.201800019","article-title":"Self-controlled case series studies: Just how rare does a rare non-recurrent outcome need to be?","volume":"60","author":"Whitaker","year":"2018","journal-title":"Biom. J."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Farrington, P., Whitaker, H., and Weldeselassie, Y.G. (2018). Self-Controlled Case Series Studies: A Modelling Guide with R., CRC Press.","DOI":"10.1201\/9780429491313"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v084.i06","article-title":"tmap: Thematic Maps in R","volume":"84","author":"Tennekes","year":"2018","journal-title":"J. Stat. Softw."},{"key":"ref_20","unstructured":"Leung, H.B., Ho, Y.C., Wong, W.C., and Guerin, J. (2007). Seasonal variations in non-traumatic major lower limb amputation in Hong Kong Chinese diabetic patients. Hong Kong Med. J., 13."},{"key":"ref_21","first-page":"201","article-title":"Seasonal Variations and Hospitalization Due to Diabetic Foot Complications","volume":"17","author":"Jehan","year":"2013","journal-title":"J. Rawalpindi Med. Coll."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/17\/9191\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:53:30Z","timestamp":1760165610000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/17\/9191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,31]]},"references-count":21,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["ijerph18179191"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18179191","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2021,8,31]]}}}