Title Page
Contents
ABSTRACT 8
국문초록 9
Ⅰ. Introduction 10
1. Introduction 1 10
2. Introduction 2 11
Ⅱ. Study Purpose 12
Ⅲ. Research Materials, Subjects, and Methods 13
1. Research Materials and Subjects 13
2. Methods 14
2.1. Subjects 14
2.2. Variables 15
2.3. Analysis Methods 17
Ⅳ. Results 18
1. Analysis of All Variables and Frequency of Operations and Procedures 18
2. Association between each analysis variable and diabetic foot exacerbation region. 20
1) Between Climate factor and DTR 20
2) Between Climate factor and Relative Humidity 21
3) Between Climate factor and Mean Temperature 21
4) Between Air quality and SO2 23
5) Between Air quality and CO 24
6) Between Air quality and NO2 25
7) Between Air quality and O3 26
8) Between Air quality and PM10 27
9) Between Air quality and PM2.5 28
Ⅴ. Discussion 29
Ⅵ. Conclusion 34
Reference 35
Appendices 38
Appendix 1. 각 연도별 하지동맥 시술 및 수술, 하지절단 수술의 시행 건수 38
Appendix 2. 세가지 다른 시계혈 분해 방법을 사용하여 분석한 당뇨발 환자의 월별 악화 추세 (고해상도 Table) 39
Appendix 3. 지역별 일교차와 당뇨발 악화의 연관성 40
Appendix 4. 지역별 습도와 당뇨발 악화의 연관성 41
Appendix 5. 지역별 온도와 당뇨발 악화의 연관성 42
Appendix 6. 지역별 이산화황(SO2) 농도와 당뇨발 악화의 연관성 43
Appendix 7. 지역별 일산화탄소(CO) 농도와 당뇨발 악화의 연관성 44
Appendix 8. 지역별 이산화질소(NO2) 농도와 당뇨발 악화의 연관성 45
Appendix 9. 지역별 오존(O3) 농도와 당뇨발 악화의 연관성 46
Appendix 10. 지역별 10μm 입자 농도와 당뇨발 악화의 연관성 47
Appendix 11. 지역별 2.5μm 미세먼지 농도와 당뇨발 악화의 연관성 48
Table 1. Subjects' characteristics and distribution by region according to age, sex, and underlying conditions 15
Table 2. Climatic and Air Quality Variables 16
Table 3. The operational definition of the event of diabetic foot deterioration. Surgery codes for lower limb artery procedures and operations and lower extremity amputations... 16
Figure 1. Schema of environmental factors (climatic and air quality changes) analysis affecting aggravation of diabetic foot ulcers 13
Figure 2. Schematics of Subject Selection 14
Figure 3. Frequencies of lower limb artery procedures, lower limb artery operations, and lower limb amputation in diabetic foot patients. A: Frequency of all procedures and... 18
Figure 4. Trends in monthly lower limb amputation rates of diabetic foot patients analyzed using three different time series decomposition methods. (A) X11-ARIMA: integrated autoregressive moving averages processes, (B) SEATS: seasonal extraction in ARIMA time series, and (C) STL: seasonal and trend decomposition using Loess methods. (Note) Black line: Adjusted amputation rate by each... 19
Figure 5. Correlation of diabetic foot amputation risk according to daily temperature difference by region in Korea. Significant results were shown on all... 20
Figure 6. Correlation of diabetic foot amputation risk according to relative humidity by region in Korea. A high correlation was confirmed in relation to... 21
Figure 7. Overall cumulative risk ratio of exacerbation of diabetic foot according to average temperature in each region. 22
Figure 8. Correlation of diabetic foot amputation risk according to atmospheric sulfur dioxide concentration by region in Korea. 23
Figure 9. Correlation of diabetic foot amputation risk according to atmospheric carbon monoxide concentration by region in Korea. 24
Figure 10. Correlation of diabetic foot amputation risk according to atmospheric carbon monoxide concentration by region in Korea. 25
Figure 11. Correlation of diabetic foot amputation risk according to atmospheric ozone concentration by region in Korea. 26
Figure 12. Depending on the concentration of 10 μm particles in the air by region in Korea Correlation of diabetic foot amputation risk. 27
Figure 13. Depending on the concentration of 2.5 μm fine dust in the air by region in Korea Correla tion of diabetic foot amputation risk. 28