CoChat
Sign Up
Cited by 9Skin Diseases and DiabetesDiabetic Foot Ulcer Assessment and ManagementDiabetes, Cardiovascular Risks, and Lipoproteins

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

Open access
Iacopi, Elisabetta, Riitano, Nicola, Dini, Valentina, Berta, Rossana Daniela, Pieruzzi, Letizia, Janowska, Agata, Anselmino, Marco, Piaggesi, Alberto +1 more·2020·Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
DOI 10.2147/dmso.s229042PMC PMC7083633
Open this paper in CoChat — free account

Abstract

AIM: To evaluate the distinct contribution of obesity and diabetes (DM) to the skin modification in metabolic diseases. METHODS: , with (Group 1) or without (Group 2) DM and compared them with a group of nonobese diabetic patients (Group 3) and healthy volunteers (Group 4). The following features were evaluated: hardness, temperature, hydration and thickness alongside with anthropometric measures of foot and leg. RESULTS: 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. CONCLUSION: 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.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.2147/dmso.s229042

Cites

29 of 29 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Publications that experimentally and explicitly demonstrate the effect of obesity or BMI on the PPG waveform are limited.

    “While, to the authors’ knowledge, publications that experimentally and explicitly demonstrate the effect of obesity or BMI on the PPG waveform are limited, we will explore works which suggest that there would be a substantial effect [56,59,60,61,62,63,64,65,66,67,68,69,70].”

    From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [60]

  • Obesity can lead to changes in skin thickness, blood flow, and oxygen saturation, affecting the optical properties of skin and the distance light has to travel to reach a target vessel.

    “In particular, obesity can lead to changes in skin thickness, blood flow, and oxygen saturation. This affects the optical properties of skin in addition to the distance light has to travel to reach a target vessel or vessels [48,59,60].”

    From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [60]

  • The skin of the foot of obese patients is about 7 degrees Celsius higher than the foot of nonobese patients.

    “For example, Iacopi et al. found the skin of the foot of obese patients to be about 7 degrees Celsius higher than the foot of nonobese patients, and thus caution should be noted if PPG is measured at the foot [60].”

    From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [60]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Iacopi, E., Riitano, N., Dini, V., Berta, R. D., Pieruzzi, L., Janowska, A., Anselmino, M., Piaggesi, A., & Romanelli, M.
Affiliations
Azienda Ospedaliera Universitaria Pisana (IT)
Corresponding author
Romanelli, Marco
ORCID
Venue
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
Publisher
Informa UK Limited
Published
2020-03
Volume
Volume 13
Pages
729-738
ISSN
1178-7007 (ISSN-L)
DOI
10.2147/dmso.s229042
PMC
PMC7083633
OpenAlex
W3011964114
Cited by
9
References
29
Citations by year
2026: 2 · 2025: 3 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 1
FWCI
0.73
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes Metabolic Syndrome and Obesity (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
Topics
  • Health Sciences › Medicine › Dermatology › Skin Diseases and Diabetes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
morbid obesity, diabetes mellitus, foot anthropometry, skin hydration, skin temperature, skin thickness, subcutaneous tissue, plantar aponeurosis, foot ulcer, biomechanical stress, anhydrosis

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review