Peer-reviewedCC BY-NC-NDJournal of diabetes investigation20 Oct 2026

Association between thyroid feedback quantile-based index and the risk of in-hospital amputation in patients with diabetic foot ulcer.

Jiale Wang^1,2
Yujie Huang¹
Funeng Wang^1,2
Meiling Lao^1,2
Lijun Lan¹
Peiling Liang^1,2

¹The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Foshan, Guangdong, China.
²Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, China.

Abstract

Aims

To investigate the relationship between the thyroid feedback quantile-based index (TFQI) and the risk of amputation during hospitalization in patients with diabetic foot ulcers (DFU).Methods

This single-center retrospective study included 381 hospitalized patients with DFU and normal thyroid function. Logistic regression assessed continuous TFQI and quartiles. Model 1 was unadjusted; Model 2 adjusted for age, sex, BMI, and smoking; Model 3 additionally adjusted for diabetes duration, HbA1c, diabetic peripheral neuropathy, peripheral arterial disease, hypertension, CRP, and dyslipidemia. RCS assessed dose-response patterns; Firth regression was used for sensitivity analysis.Results

Fifty-six patients underwent amputation. In Model 3, each 1-SD increase in TFQI (equivalent to a 1-unit increase in pre-scaled TFQI) was associated with higher odds of amputation (OR 2.27, 95% CI 1.63-3.15; P < 0.001). Compared with Q1, ORs were 2.94 (0.98-8.83; P = 0.055), 5.60 (1.88-16.67; P = 0.002), and 14.79 (5.22-41.89; P < 0.001) for Q2, Q3, and Q4, respectively. RCS showed an overall association (P = 0.002) and nonlinearity (P = 0.046) in Model 3. Firth estimates were broadly consistent with conventional regression.Conclusion

Among hospitalized DFU patients with normal thyroid function, higher TFQI levels are associated with an increased risk of amputation during hospitalization. Nevertheless, the clinical utility of TFQI requires further validation in prospective studies.

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Cite

BibTeX RIS

BibTeX

@article{wang2026association,
  title = {{Association between thyroid feedback quantile-based index and the risk of in-hospital amputation in patients with diabetic foot ulcer.}},
  author = {Jiale Wang and Yujie Huang and Funeng Wang and Meiling Lao and Lijun Lan and Peiling Liang},
  journal = {Journal of diabetes investigation},
  year = {2026},
  month = oct,
  doi = {10.1111/jdi.70472},
  url = {https://europepmc.org/article/MED/42899554},
  note = {CC BY-NC-ND},
}

RIS

TY  - JOUR
TI  - Association between thyroid feedback quantile-based index and the risk of in-hospital amputation in patients with diabetic foot ulcer.
AU  - Jiale Wang
AU  - Yujie Huang
AU  - Funeng Wang
AU  - Meiling Lao
AU  - Lijun Lan
AU  - Peiling Liang
PY  - 2026
DA  - 2026/10/20
JO  - Journal of diabetes investigation
DO  - 10.1111/jdi.70472
UR  - https://europepmc.org/article/MED/42899554
AB  - Aims  To investigate the relationship between the thyroid feedback quantile-based index (TFQI) and the risk of amputation during hospitalization in patients with diabetic foot ulcers (DFU).Methods  This single-center retrospective study included 381 hospitalized patients with DFU and normal thyroid function. Logistic regression assessed continuous TFQI and quartiles. Model 1 was unadjusted; Model 2 adjusted for age, sex, BMI, and smoking; Model 3 additionally adjusted for diabetes duration, HbA1c, diabetic peripheral neuropathy, peripheral arterial disease, hypertension, CRP, and dyslipidemia. RCS assessed dose-response patterns; Firth regression was used for sensitivity analysis.Results  Fifty-six patients underwent amputation. In Model 3, each 1-SD increase in TFQI (equivalent to a 1-unit increase in pre-scaled TFQI) was associated with higher odds of amputation (OR 2.27, 95% CI 1.63-3.15; P < 0.001). Compared with Q1, ORs were 2.94 (0.98-8.83; P = 0.055), 5.60 (1.88-16.67; P = 0.002), and 14.79 (5.22-41.89; P < 0.001) for Q2, Q3, and Q4, respectively. RCS showed an overall association (P = 0.002) and nonlinearity (P = 0.046) in Model 3. Firth estimates were broadly consistent with conventional regression.Conclusion  Among hospitalized DFU patients with normal thyroid function, higher TFQI levels are associated with an increased risk of amputation during hospitalization. Nevertheless, the clinical utility of TFQI requires further validation in prospective studies.
SN  - 2040-1116
SN  - 2040-1124
ER  -

Abstract

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