NUNES, M. A. L.; CARNEIRO, V. S.; http://lattes.cnpq.br/4321232528880569; http://lattes.cnpq.br/6395751930253406; NUNES, Marcos André Lima.; CARNEIRO, Vitor Sarmento.
Resumo:
Introduction: Among Diabetic neuropathic Foot Complications the Charcot
neuroarthropathy (CN) is noteworthy, threatening condition to the lower limbs and lives
of people with diabetes mellitus. It is a noninfectious inflammatory disease marked by
disorganization in various stages of joint and bone. The delay in the diagnosis of more
than three months adversely affects the quality of life of patients and functional
outcome of the disease. Materials and Methods: a systematic review were performed
of the literature Published in the period between July 2005 and July 2015, guided by
the question: What are the modifiable risk factors of early onset in diabetic patients
leading to CN? The following databases were consulted: PubMed, Web of Science,
Scopus and Lilacs. Articles found have gone through a selection protocol. Results:
Were found 400 articles, however, after the selection protocol, 13 were chosen. These
articles had the following risk factors: non-Hispanic whites ethnic and aboriginal,
diabetes duration, social isolation, previous foot ulcer, obesity isolated or associated
with neuropathy, high levels of HbA1c, chronic use of high doses of corticosteroids,
increased maximal response of vascular hyperemia, renal failure, rheumatoid arthritis,
iron deficiency anemia, use of insulin, presence of micro and macrovascular
complications, lack of CC genotypes and TT [frequency of the C allele (gene in
G1181C) + T (T245G gene)] and the presence of polymorphisms 1181G> C and 950T>
C in the osteoprotegerin gene. As a protective factor, we found peripheral arterial
disease. The risk factor age was controversial. Conclusion: Many risk factors are
related to an inefficient management of diabetes mellitus, indicating poor health care
to this group of patients. Others are related to socio-demographic and genetic
characteristics. Knowledge of modifiable risk factors for early onset of CN in the
diabetic can result in a more efficient preventive clinical approach. However, further
investigations are necessary to validate, refute or expand perceptions and approaches
to modifiable risk factors for CN.