Hospital for Special Surgery, New York, NY 10021, USA.
J Orthop Res. 2011 Jun;29(6):880-5. doi: 10.1002/jor.21327. Epub 2011 Jan 18.
The purpose of this study was to determine the effect of the diabetic phenotype on the mechanical properties of the native patellar tendon and its enthesis. Diabetes was induced via intraperitoneal injection of streptozotocin in Lewis rats. Control (n = 18) and diabetic animals (n = 20) were killed at 12 and 19 days for analysis. Statistical comparisons were performed using Student's t-tests and a two-tailed Fisher test with significance set at p < 0.05. Pre- and post-injection intraperitoneal glucose tolerance tests demonstrated significant impairment of glycemic control in the diabetic compared to control animals (p = 0.001). Mean serum hemoglobin A1c levels at 19 days was 10.6 ± 2.7% and 6.0 ± 1.0% for the diabetic and control groups, respectively (p = 0.0001). Fifteen of sixteen diabetic animals demonstrated intrasubstance failure of the patellar tendon, while only 7 of 14 control specimens failed within the tendon substance. The Young's modulus of the diabetic tendon was significantly lower than control specimens by 19 days post-induction (161 ± 10 N m(-2) compared to 200 ± 46 N m(-2) , respectively) (p = 0.02). The metabolic condition of poorly controlled diabetes negatively affects the mechanical properties of the native patellar tendon. These altered structural properties may predispose diabetic patients to a greater risk of tendinopathy and/or traumatic rupture.
本研究旨在确定糖尿病表型对髌腱及其附着点的力学性能的影响。通过链脲佐菌素（streptozotocin）腹腔注射诱导 Lewis 大鼠产生糖尿病。12 天和 19 天时处死对照组（n=18）和糖尿病组（n=20）动物用于分析。使用 Student's t 检验和双侧 Fisher 检验进行统计比较，显著性水平设置为 p<0.05。注射前和注射后腹腔葡萄糖耐量试验显示，与对照组相比，糖尿病组的血糖控制明显受损（p=0.001）。19 天时，糖尿病组和对照组的平均血清糖化血红蛋白水平分别为 10.6±2.7%和 6.0±1.0%（p=0.0001）。16 只糖尿病动物中有 15 只髌腱发生了内部断裂，而对照组中只有 14 只中有 7 只在腱内断裂。糖尿病组肌腱的杨氏模量在诱导后 19 天明显低于对照组（161±10 N m-2比 200±46 N m-2）（p=0.02）。控制不良的糖尿病的代谢状况对髌腱的力学性能有负面影响。这些改变的结构特性可能使糖尿病患者更容易发生腱病和/或外伤性断裂。
