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已发表论文
糖尿病与肛周脓肿之间的关联：一项荟萃分析
Authors Zhang H, Gao X, Qu Y, Chen J, Liu H
Received 6 June 2025
Accepted for publication 24 November 2025
Published 4 December 2025 Volume 2025:18 Pages 4449—4463
DOI https://doi.org/10.2147/DMSO.S543521
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Hillary Keenan
Hui Zhang,1 Xiang Gao,1 Yuanming Qu,2 Jia Chen,2 Hantao Liu1
1Graduate School of Clinical Medical College of Traditional Chinese Medicine, Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region, People’s Republic of China; 2Anorectal Center, Traditional Chinese Medicine Hospital of Inner Mongolia Autonomous Region, Hohhot, Inner Mongolia Autonomous Region, People’s Republic of China
Correspondence: Yuanming Qu, Anorectal Center, Traditional Chinese Medicine Hospital of Inner Mongolia Autonomous Region, Hohhot, Inner Mongolia Autonomous Region, People’s Republic of China, Email 353137605@qq.com
Introduction: Perianal abscess (PA), a common anorectal emergency, affects approximately 2– 3% of the global population. Increasing evidence indicates a relationship between PA and metabolic disorders. Considering the anticipated rise in diabetes mellitus (DM) cases to 1 billion worldwide by 2045, clarifying the epidemiological association and clinical characteristics linking glucose dysregulation with PA holds considerable clinical importance.
Purpose: This study aimed to elucidate the bidirectional epidemiological relationship between DM and PA and to define their respective clinical profiles, thereby contributing to risk stratification and optimization of management strategies.
Methods: Observational studies examining the association between DM and PA were systematically retrieved from PubMed, EMBASE, Cochrane Library, CNKI, Wanfang, and VIP databases (from inception to November 2024). Two independent reviewers conducted study selection, data extraction, and quality assessment using the Newcastle-Ottawa Scale. Random-effects models were applied to calculate pooled prevalence, odds ratios (OR), relative risks (RR), and 95% confidence intervals (CI). Heterogeneity, sensitivity, and publication bias were evaluated using Cochran’s Q test, I2 statistics, subgroup analyses, and Egger’s test.
Results: The meta-analysis demonstrated a strong bidirectional association between DM and PA, with 30.7% of PA cases occurring in patients with DM and 22.0% of individuals with DM developing PA. Male sex conferred a significantly higher risk (OR=15.00, 95% CI: 7.87– 28.59). DM was linked to altered microbial profiles—lower prevalence of Escherichia coli (OR=0.57, 95% CI: 0.39– 0.84) and higher detection of Klebsiella pneumoniae (OR=4.73, 95% CI: 1.30– 17.19)—as well as increased occurrence of high abscesses (OR=1.72, 95% CI: 1.00– 2.94), older age at onset (+5.53 years), and higher recurrence rates compared with non-DM patients.
Conclusion: The interrelationship between DM and PA is characterized by mutual risk amplification and distinct clinical manifestations, including sex-related vulnerability, microbial alterations, and poorer prognostic outcomes. These findings indicate the necessity for individualized antimicrobial regimens and enhanced postoperative monitoring in patients with DM.
Keywords: hyperglycemia, anorectal infection, comorbidity, evidence-based medicine
1Graduate School of Clinical Medical College of Traditional Chinese Medicine, Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region, People’s Republic of China; 2Anorectal Center, Traditional Chinese Medicine Hospital of Inner Mongolia Autonomous Region, Hohhot, Inner Mongolia Autonomous Region, People’s Republic of China
Correspondence: Yuanming Qu, Anorectal Center, Traditional Chinese Medicine Hospital of Inner Mongolia Autonomous Region, Hohhot, Inner Mongolia Autonomous Region, People’s Republic of China, Email 353137605@qq.com
Introduction: Perianal abscess (PA), a common anorectal emergency, affects approximately 2– 3% of the global population. Increasing evidence indicates a relationship between PA and metabolic disorders. Considering the anticipated rise in diabetes mellitus (DM) cases to 1 billion worldwide by 2045, clarifying the epidemiological association and clinical characteristics linking glucose dysregulation with PA holds considerable clinical importance.
Purpose: This study aimed to elucidate the bidirectional epidemiological relationship between DM and PA and to define their respective clinical profiles, thereby contributing to risk stratification and optimization of management strategies.
Methods: Observational studies examining the association between DM and PA were systematically retrieved from PubMed, EMBASE, Cochrane Library, CNKI, Wanfang, and VIP databases (from inception to November 2024). Two independent reviewers conducted study selection, data extraction, and quality assessment using the Newcastle-Ottawa Scale. Random-effects models were applied to calculate pooled prevalence, odds ratios (OR), relative risks (RR), and 95% confidence intervals (CI). Heterogeneity, sensitivity, and publication bias were evaluated using Cochran’s Q test, I2 statistics, subgroup analyses, and Egger’s test.
Results: The meta-analysis demonstrated a strong bidirectional association between DM and PA, with 30.7% of PA cases occurring in patients with DM and 22.0% of individuals with DM developing PA. Male sex conferred a significantly higher risk (OR=15.00, 95% CI: 7.87– 28.59). DM was linked to altered microbial profiles—lower prevalence of Escherichia coli (OR=0.57, 95% CI: 0.39– 0.84) and higher detection of Klebsiella pneumoniae (OR=4.73, 95% CI: 1.30– 17.19)—as well as increased occurrence of high abscesses (OR=1.72, 95% CI: 1.00– 2.94), older age at onset (+5.53 years), and higher recurrence rates compared with non-DM patients.
Conclusion: The interrelationship between DM and PA is characterized by mutual risk amplification and distinct clinical manifestations, including sex-related vulnerability, microbial alterations, and poorer prognostic outcomes. These findings indicate the necessity for individualized antimicrobial regimens and enhanced postoperative monitoring in patients with DM.
Keywords: hyperglycemia, anorectal infection, comorbidity, evidence-based medicine