Using Skin Bioengineering to Highlight How Weight and Diabetes Mellitus Modify the Skin in the Lower Limbs of Super-Obese Patients.

diabetes obesity skin disease

Journal

Diabetes, metabolic syndrome and obesity : targets and therapy
ISSN: 1178-7007
Titre abrégé: Diabetes Metab Syndr Obes
Pays: New Zealand
ID NLM: 101515585

Informations de publication

Date de publication:
2020
Historique:
received: 28 08 2019
accepted: 24 12 2019
entrez: 28 3 2020
pubmed: 28 3 2020
medline: 28 3 2020
Statut: epublish

Résumé

To evaluate the distinct contribution of obesity and diabetes (DM) to the skin modification in metabolic diseases. We analysed all patients admitted for bariatric surgery in our hospital with BMI between 38 and 47 kg/m For the general characteristics, patients differed in age and body mass index. As predictable all circumferences (dorsal foot, sovramalleolar and under the knee) were significantly higher in obese with no differences depending on DM (all parameters: p<0.01 in Group 1 and Group 2 vs Group 3 and Group 4). Skin temperature was significantly higher in all obese, irrespectively from the presence of DM (1st metatarsal head: p=0.02 Group 1 and Group 2 vs Group 3 and Group 4; 5th metatarsal head: p<0.01 in Group 1 and Group 2 vs Group 3 and Group 4). Skin hydration score showed increased anhydrosis in both diabetics and severe obesity (p<0.01 in Group 1 and Group 3 vs Group 2 and Group 4). Increase in thickness of skin and subcutaneous tissues was observed (at heel: p<0.01 in Group 1 and Group 2 vs Group 3 and Group 4 and under the scaphoid p=0.03 Group 1 and Group 2 vs Group 3 and Group 4) and plantar fascia (in both regions p=0.02 Group 1 and Group 2 vs Group 3 and Group 4) in all obese patients, with or without DM. Severe obesity significantly affects both shape and structure of the foot, possibly exposing these patients to a higher risk of biomechanical stress. On such a background DM, modifying skin hydration and protective mechanisms exerts a synergistic role further increasing the risk of trauma and ulcers.

Identifiants

pubmed: 32214836
doi: 10.2147/DMSO.S229042
pii: 229042
pmc: PMC7083633
doi:

Types de publication

Journal Article

Langues

eng

Pagination

729-738

Informations de copyright

© 2020 Iacopi et al.

Déclaration de conflit d'intérêts

The authors report no conflicts of interest in this work.

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Auteurs

Elisabetta Iacopi (E)

Diabetic Foot Section, Pisa University Hospital, Pisa, Italy.

Nicola Riitano (N)

Diabetic Foot Section, Pisa University Hospital, Pisa, Italy.
Dermatology Department, Pisa University Hospital, Pisa, Italy.

Valentina Dini (V)

Dermatology Department, Pisa University Hospital, Pisa, Italy.

Rossana Berta (R)

Bariatric Surgery Unit, Pisa University Hospital, Pisa, Italy.

Letizia Pieruzzi (L)

Diabetic Foot Section, Pisa University Hospital, Pisa, Italy.

Agata Janowska (A)

Dermatology Department, Pisa University Hospital, Pisa, Italy.

Marco Anselmino (M)

Bariatric Surgery Unit, Pisa University Hospital, Pisa, Italy.

Alberto Piaggesi (A)

Diabetic Foot Section, Pisa University Hospital, Pisa, Italy.

Marco Romanelli (M)

Dermatology Department, Pisa University Hospital, Pisa, Italy.

Classifications MeSH