Gustafsson Patrik, Crenshaw Albert G, Edmundsson David, Toolanen Göran, Crnalic Sead
Department of Surgical and Perioperative Sciences (Orthopaedics), Umeå University, Umeå, Sweden.
Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
PLoS One. 2017 Oct 23;12(10):e0186790. doi: 10.1371/journal.pone.0186790. eCollection 2017.
Type 1 diabetic patients and non-diabetic patients were referred for evaluation for chronic exertional compartment syndrome (CECS) based on clinical examination and complaints of activity-related leg pain in the region of the tibialis anterior muscle. Previous studies using near-infrared spectroscopy (NIRS) showed greater deoxygenation during exercise for CECS patients versus healthy controls; however, this comparison has not been done for diabetic CECS patients.
We used NIRS to test for differences in oxygenation kinetics for Type 1 diabetic patients diagnosed with (CECS-diabetics, n = 9) versus diabetic patients without (CON-diabetics, n = 10) leg anterior chronic exertional compartment syndrome. Comparisons were also made between non-diabetic CECS patients (n = 11) and healthy controls (CON, n = 10). The experimental protocol consisted of thigh arterial cuff occlusion (AO, 1-minute duration), and treadmill running to reproduce symptoms. NIRS variables generated were resting StO2%, and oxygen recovery following AO. Also, during and following treadmill running the magnitude of deoxygenation and oxygen recovery, respectively, were determined.
There was no difference in resting StO2% between CECS-diabetics (78.2±12.6%) vs. CON-diabetics (69.1±20.8%), or between CECS (69.3±16.2) vs. CON (75.9±11.2%). However, oxygen recovery following AO was significantly slower for CECS (1.8±0.8%/sec) vs. CON (3.8±1.7%/sec) (P = 0.002); these data were not different between the diabetic groups. StO2% during exercise was lower (greater deoxygenation) for CECS-diabetics (6.3±8.6%) vs. CON-diabetics (40.4±22.0%), and for CECS (11.3±16.8%) vs. CON (34.1±21.2%) (P<0.05 for both). The rate of oxygen recovery post exercise was faster for CECS-diabetics (3.5±2.6%/sec) vs. CON-diabetics (1.4±0.8%/sec) (P = 0.04), and there was a tendency of difference for CECS (3.1±1.4%/sec) vs. CON (1.9±1.3%/sec) (P = 0.05).
The greater deoxygenation during treadmill running for the CECS-diabetics group (vs. CON-diabetics) is in line with previous studies (and with the present study) that compared non-diabetic CECS patients with healthy controls. Our findings could suggest that NIRS may be useful as a diagnostic tool for assessing Type 1 diabetic patients suspected of CECS.
1型糖尿病患者和非糖尿病患者因临床检查及胫前肌区域与活动相关的腿部疼痛主诉而被转诊以评估慢性运动性骨筋膜室综合征（CECS）。既往使用近红外光谱（NIRS）的研究表明，与健康对照组相比，CECS患者在运动期间的脱氧程度更高；然而，尚未对糖尿病CECS患者进行此类比较。
我们使用NIRS检测诊断为腿部前侧慢性运动性骨筋膜室综合征的1型糖尿病患者（CECS - 糖尿病组，n = 9）与无该综合征的糖尿病患者（对照 - 糖尿病组，n = 10）之间的氧合动力学差异。还对非糖尿病CECS患者（n = 11）和健康对照组（对照，n = 10）进行了比较。实验方案包括大腿动脉袖带阻断（AO，持续1分钟）以及在跑步机上跑步以重现症状。生成的NIRS变量包括静息状态下的组织氧饱和度（StO2%）以及AO后的氧恢复情况。此外，在跑步机跑步期间及之后分别测定脱氧程度和氧恢复程度。
CECS - 糖尿病组（78.2±12.6%）与对照 - 糖尿病组（69.1±20.8%）之间，以及CECS组（69.3±16.2）与对照组（75.9±11.2%）之间，静息StO2%无差异。然而，CECS组（1.8±0.8%/秒）与对照组（3.
