欢迎来到OAJRC平台！

核心 CSCIED

期刊栏目

投稿

审稿

期刊目次

加入编委

期刊订阅

添加您的邮件地址以接收即将发行期刊数据：

当前位置：国际临床研究杂志 > 2026年 10卷 (8)期

Open Access Article

International Journal of Clinical Research. 2026; 10: (8) ; 23-28 ; DOI: 10.12208/j.ijcr.20260376.

Plantar pressure in patients with type 2 Diabetes Mellitus with obesity/overweight
2型糖尿病合并肥胖或超重患者足底压力最新研究进展

作者： 崔灏灵, 朱恩芳, 段中平, 毛舰, 桂莉, 朱宏, 李文 *

大理大学第二附属医院内分泌科（云南省第三人民医院）云南昆明

*通讯作者：李文,单位：大理大学第二附属医院内分泌科（云南省第三人民医院）云南昆明；

国家自然科学基金资助项目计划书（项目编号：82360717）

发布时间: 2026-08-06 总浏览量: 104 下载量: 加载中...

PDF 全文下载引用本文

摘要

2型糖尿病合并肥胖或超重已成为全球重大公共卫生问题，加剧足底压力分布异常风险，易并发神经血管病变，不仅导致足部肌肉萎缩、感觉减退甚至丧失，还会引发下肢循环障碍，进而显著改变足底压力分布。此外，肥胖或超重患者总胆固醇和甘油三酯升高易诱发血管斑块形成，使血管管壁增厚、变硬、管腔狭窄，且下肢脂肪组织异常堆积引起血管外周压力增加、血管受压、血流阻力增大，进一步影响下肢血液供应，加剧足底压力分布的不均匀性。足底压力分布异常是诱发跖痛症、足底筋膜炎、鸡眼及胼胝等足部并发症的重要诱因。神经病变和血管病变的协同作用导致足底压力分布不均，显著提升糖尿病足溃疡发生风险。本文旨在厘清该领域研究空白，为构建“未病先防、既病防变”的防控体系提供理论依据。本文通过检索PubMed、知网及万方等数据库中关于2型糖尿病合并肥胖或超重患者足底压力的相关文献，重点分析病理机制、评估技术及干预策略。结果显示：1）2型糖尿病患者代谢异常与肥胖或超重机械负荷形成“双重打击”，通过神经病变、血管缺血及结构改变三条通路加重足底压力异常；2）体质量指数（BMI）、糖化血红蛋白（HbA1c）>8%的患者足底压力异常风险增加；3）做到“标本兼治”，通过减重5%~10%及严格控制HbA1c，改善神经病变、血管缺血的内环境；4）定制鞋垫或减压鞋具分散足底高压，指导患者进行日常足部护理，实现从被动治疗向主动预防的转变。

关键词： 2型糖尿病；肥胖；超重；足底压力；糖尿病足

Abstract

Type 2 diabetes mellitus (T2DM) and overweight or obesity represents a global public health burden. The comorbidity exacerbates the risk of abnormal plantar pressure distribution and predisposes individuals to neurovascular complications. The pathologies induce foot muscle atrophy and sensory impairment, while concurrently triggering lower extremity circulatory disturbances that fundamentally alter plantar loading patterns. Furthermore, elevated cholesterol and triglyceride promote vascular plaque formation, resulting in vessel wall thickening, stiffening, and luminal narrowing. Concurrently, lower limb adipose accumulation increases perivascular pressure, compresses vasculature, and elevates flow resistance, thereby compromising peripheral blood supply and worsening pressure heterogeneity. Abnormal plantar pressure serves as a key etiological factor for foot complications, including metatarsalgia, plantar fasciitis, corns, and calluses. The synergistic effect of neuropathy and vasculopathy leads to uneven pressure distribution, significantly elevating the risk of diabetic foot ulcers (DFU). The review aims to identify existing research gaps and provide a theoretical basis for establishing a closed-loop prevention system focused on “prevention before disease onset” and “prevention of progression.” We conducted a literature search across PubMed, CNKI, and Wanfang databases to integrate current evidence regarding plantar pressure in overweight or obese T2DM patients, focusing specifically on pathological mechanisms, assessment technologies, and intervention strategies. The researches reveal key points: 1) The metabolic dysregulation of T2DM and the mechanical overload of obesity constitute a “dual-hit” mechanism, exacerbating plantar pressure abnormalities through neuropathy, vascular ischemia, and structural alterations; 2) Higher body mass index (BMI) and HbA1c > 8% are associated with an increased risk of abnormal plantar pressure in patients with diabetes; 3) Achieving “treating both symptoms and root causes” requires a dual approach: improving the neuro-ischemic microenvironment through 5%-10% weight reduction and strict HbA1c control, coupled with customized insoles or pressure-relief footwear to redistribute plantar loads. Guiding patients in daily self-examination and care facilitates a paradigm shift from passive treatment to active prevention.

Key words： Type 2 diabetes mellitus; Obesity; Overweight; Plantar pressure; Diabetic foot

参考文献 References

[1] Genitsaridi I, Salpea P, Salim A, et al. 11th edition of the IDF diabetes atlas: global, regional, and national diabetes prevalence estimates for 2024 and projections for 2050[J]. The Lancet Diabetes & Endocrinology, 2026, 14(2): 149-156.

[2] Zeng Q, Li N, Pan X F, et al. Clinical management and treatment of obesity in China[J]. Lancet Diabetes and Endocrinology, 2021, 9(6): 393-405.

[3] Wang L, Zhou B, Zhao Z, et al. Body-mass index and obesity in urban and rural china: findings from consecutive nationally representative surveys during 2004–18[J]. Lancet, 2021, 398(10294): 53-63.

[4] Pan X F, Wang L, Pan A. Epidemiology and determinants of obesity in China[J]. Lancet Diabetes and Endocrinology, 2021, 9(6): 373-392.

[5] 鹿亮, 孙怡宁, 马祖长. 糖尿病足底压力研究进展[J]. 中华骨与关节外科杂志, 2024, 17(6): 566-572.

[6] Ahmad E, Lim S, Lamptey R, et al. Type 2 diabetes[J]. Lancet, 2022, 400(10365): 1803-1820.

[7] Kawai T, Autieri M V, Scalia R. Adipose tissue inflammation and metabolic dysfunction in obesity[J]. American Journal of Physiology-Cell Physiology, 2021, 320(3): C375-C391.

[8] 中华医学会糖尿病学分会, 中华医学会感染病学分会, 中华医学会组织修复与再生分会. 中国糖尿病足防治指南（2019版）（Ⅲ）[J]. 中华糖尿病杂志, 2019, 11(4): 238-247.

[9] 胡丹, 赵蒙蒙. 基于生理监控的智能可穿戴服装研究[J]. 针织工业, 2024(6): 59-64.

[10] 程翔, 郭瑞, 伍晓明, 等. 可穿戴式足底压力监测系统的应用及进展[J]. 机器人外科学杂志（中英文）, 2024, 5(2): 143-147.

[11] Hafer J F, Lenhoff M W, Song J, et al. Reliability of plantar pressure platforms[J]. Gait & Posture, 2013, 38(3): 544-548.

[12] 王兰美,郭业民,潘志国. 人体足底压力分布研究与应用[J]. 机械制造与自动化, 2005(1): 35-38.

[13] 王静, 王晖, 苗宇宽, 等. 2型糖尿病周围神经病变患者足底动静态压力参数比较及相关因素分析[J]. 实用医学杂志, 2025, 41(4): 522-528.

[14] Hafer J F, Lenhoff M W, Song J, et al. Reliability of plantar pressure platforms[J]. Gait & Posture, 2013, 38(3): 544-548.

[15] Hemler S L, Ntella S L, Jeanmonod K, et al. Intelligent plantar pressure offloading for the prevention of diabetic foot ulcers and amputations[J]. Frontiers in Endocrinology, 2023, 14: 1166513.

[16] 鹿亮, 孙怡宁, 马祖长. 糖尿病足底压力研究进展[J]. 中华骨与关节外科杂志, 2024, 17(6): 566-572.

[17] 王静. 2型糖尿病周围神经病变患者足底动静态压力参数比较及相关因素分析[J]. 实用医学杂志, 2025, 41(04): 522.

[18] Brieger K, Schiavone S, Miller Jr, et al. Reactive oxygen species: from health to disease[J]. Swiss Medical Weekly, 2012, 1424(7860): 3997.

[19] Pellegrini V, La Grotta R, Carreras F, et al. Inflammatory trajectory of type 2 diabetes: novel opportunities for early and late treatment[J]. Cells, 2024, 13(19): 1662.

[20] Liu Z, Liang Q, Ren Y, et al. Immunosenescence: molecular mechanisms and diseases[J]. Signal Transduction and Targeted Therapy, 2023, 8(1): 200.

[21] Petrie J R, Guzik T J, Touyz R M. Diabetes, hypertension, and cardiovascular disease: clinical insights and vascular mechanisms[J]. Canadian Journal of Cardiology, 2018, 34(5): 575-584.

[22] Zhu J, Hu Z, Luo Y, et al. Diabetic peripheral neuropathy: pathogenetic mechanisms and treatment[J]. Frontiers in Endocrinology, 2024, 14: 1265372.

[23] Armstrong D G, Tan T W, Boulton A J M, et al. Diabetic foot ulcers: a review[J]. JAMA, 2023, 330(1): 62.

[24] Chuter V, Schaper N, Hinchliffe R, et al. Performance of non‐invasive bedside vascular testing in the prediction of wound healing or amputation among people with foot ulcers in diabetes: a systematic review[J]. Diabetes/ Metabolism Research and Reviews, 2024, 40(3): e3701.

[25] 谭琼琼, 杨丽, 朱玲棣, 等. 个体化减重干预对肥胖合并T2DM患者体质量指数、糖脂代谢的影响[J]. 中国现代医学杂志, 2022, 32(9): 84-90.

[26] Chuter V, Schaper N, Hinchliffe R, et al. Performance of non-invasive bedside vascular testing in the prediction of wound healing or amputation among people with foot ulcers in diabetes: a systematic review[J]. Diabetes/ Metabolism Research and Reviews, 2024, 40(3): e3701.

[27] Khalaf K, Mohan D M, Hindi M A, et al. Plantar pressure alterations associated with increased BMI in young adults[J]. Gait & Posture, 2022, 98: 255-260.

[28] 李文霞. 2型糖尿病患者足部的生物力学特点：303例报告[J]. 南方医科大学学报, 2016, 36(10): 1410.

[29] 戴昕, 李圆. 超重肥胖对中老年女性步态及平衡功能的影响[J]. 首都体育学院学报, 2016, 28(5): 476-480.

[30] Hills A P, Hennig E M, Byrne N M, et al. The biomechanics of adiposity – structural and functional limitations of obesity and implications for movement[J]. Obesity Reviews, 2002, 3(1): 35-43.

[31] 尚慕鸿, 王亚东, 王昕, 等. 地奥心血康调节IRS-1/PI3K/AKT信号通路改善肥胖小鼠胰岛素抵抗[J]. 安徽中医药大学学报, 2025, 44(3): 82-89.

[32] Pirri D, Tian S, Tardajos-Ayllon B, et al. EPAS1 attenuates atherosclerosis initiation at disturbed flow sites through endothelial fatty acid uptake[J]. Circulation Research, 2024, 135(8): 822-837.

[33] Kwan A C, May H T, Cater G, et al. Coronary artery plaque volume and obesity in patients with diabetes: the factor-64 study[J]. Radiology, 2014, 272(3): 690-699.

[34] Iyengar N M, Gucalp A, Dannenberg A J, et al. Obesity and cancer mechanisms: tumor microenvironment and inflammation[J]. Journal of Clinical Oncology, 2016, 34(35): 4270-4276.

[35] Bonomo R, Kramer S, Aubert V M. Obesity-associated neuropathy: recent preclinical studies and proposed mechanisms[J]. Antioxidants & Redox Signaling, 2022, 37(7-9): 597-612.

[36] 张蕾, 黄大祥, 吴方来, 等. 血清胱抑素C、铁蛋白、胰岛素抵抗指数表达水平在2型糖尿病合并肥胖患者中的诊断价值[J]. 中国现代医学杂志, 2025, 35(2): 83-88.

[37] 徐亚威, 梁拓, 马亚飞. 司美格鲁肽联合二甲双胍对肥胖2型糖尿病的疗效及对糖脂代谢和炎症因子的影响[J]. 包头医学, 2025, 49(4): 87-90.

[38] McDermott K, Fang M, Boulton A J M, et al. Etiology, epidemiology, and disparities in the burden of diabetic foot ulcers[J]. Diabetes Care, 2023, 46(1): 209-221.

[39] 王淑慧. 不同病程糖尿病患者周围神经病变电生理特点[J]. 现代电生理学杂志, 2024, 31(4): 201-204.

[40] 冯云. 超声诊断鉴别不同病程T2DM患者下肢血管病变的价值[J]. 现代医用影像学, 2022, 31(9): 1753-1756.

[41] 胡伊玢, 孟晓静. 平衡足底压力及稳定步态在早期糖尿病足防治中的意义[J]. 中国全科医学, 2013, 16(22): 1959-1963.

[42] Yıldırım Şahan T, Türker D, Söyler O. Comparison of plantar pressure distribution in underweight, normal, overweight, and obese adolescents: a cross-sectional study evaluation of plantar pressure in adolescents[J]. Prosthetics & Orthotics International, 2023, 47(1): 101-106.

[43] Butterworth P A, Urquhart D M, Landorf K B, et al. Foot posture, range of motion and plantar pressure characteristics in obese and non-obese individuals[J]. Gait and Posture, 2015, 41(2): 465-469.

[44] Khalaf K, Mohan D M, Hindi M A, et al. Plantar pressure alterations associated with increased BMI in young adults[J]. Gait and Posture, 2022, 98: 255-260.

[45] Qiong-qiong Tan. 个体化减重干预对肥胖合并T2DM患者体质量指数、糖脂代谢的影响[J]. 中国现代医学杂志, 2022, 32(9): 84-90.

引用本文

崔灏灵, 朱恩芳, 段中平, 毛舰, 桂莉, 朱宏, 李文, 2型糖尿病合并肥胖或超重患者足底压力最新研究进展[J]. 国际临床研究杂志, 2026; 10: (8) : 23-28.

入驻平台

回到顶部

搜索文章: