Centre for Biomechanics and Rehabilitation Technologies, School of Life Sciences and Education, Staffordshire University, Staffordshire, UK.
Department of Engineering, Medical Imaging Laboratory, Pontificia Universidad Catolica del Peru, Lima, Peru.
J Diabetes Sci Technol. 2022 Mar;16(2):478-490. doi: 10.1177/1932296820965259. Epub 2020 Oct 23.
The purpose of this study was to investigate the association between the mechanical properties of plantar soft tissue and diabetes status.
51 (M/F: 21/30) participants with prediabetes onset (fasting blood sugar [FBS] level > 100 mg/dL), age >18 years, and no lower limb amputation were recruited after ethical approval was granted from Pontificia Universidad Catolica del Peru ethical review board. Ultrasound reverberant shear wave elastography was used to assess the soft tissue stiffness at the 1st metatarsal head (MTH), 3rd MTH, and the heel at both feet.
Spearman's rank-order correlation (rho) test indicated a significant ( < .05) positive correlations between FBS level and the plantar soft tissue shear wave speed at the 1st MTH: = 0.402 (@400 Hz), = 0.373 (@450 Hz), = 0.474 (@500 Hz), = 0.395 (@550 Hz), and = 0.326 (@600 Hz) in the left foot and = 0.364 (@450 Hz) in the right foot. Mann-Whitney U test indicated a significantly ( < .05) higher shear wave speed in the plantar soft tissue with the following effect sizes (r) at the 1st MTH of the left foot at all tested frequencies: = 0.297 (@450 Hz), = 0.345 (@500 Hz), = 0.322 (@550 Hz), and = 0.275 (@600 Hz), and at the 1st MTH of right foot = 0.286 (@400 Hz) in diabetes as compared with the age and body mass index matched prediabetes group.
An association between fasting blood sugar level and the stiffness of the plantar soft tissue with higher values of shear wave speed in diabetes versus prediabetes group was observed. This indicated that the proposed approach can improve the assessment of the severity of diabetic foot complications with potential implications in patient stratification.
本研究旨在探讨足底软组织力学特性与糖尿病状态之间的关系。
在经过秘鲁天主教大学伦理审查委员会伦理批准后，共招募了 51 名参与者（男/女：21/30），他们患有糖尿病前期（空腹血糖[FBS]水平>100mg/dL），年龄>18 岁，无下肢截肢。使用超声背向散射剪切波弹性成像技术评估双脚第 1 跖骨头（MTH）、第 3 MTH 和足跟处的软组织硬度。
Spearman 等级相关（rho）检验表明，FBS 水平与足底软组织在第 1 MTH 的剪切波速度之间存在显著（<0.05）正相关：在左足， = 0.402（@400Hz）， = 0.373（@450Hz）， = 0.474（@500Hz）， = 0.395（@550Hz）， = 0.326（@600Hz），在右足 = 0.364（@450Hz）。Mann-Whitney U 检验表明，在糖尿病患者的第 1 MTH 处，足底软组织的剪切波速度明显较高（<0.05），且具有以下左右侧的效应量（r）：在左足，在所有测试频率下 = 0.297（@450Hz）， = 0.345（@500Hz）， = 0.322（@550Hz）， = 0.275（@600Hz），在右足 = 0.286（@400Hz），与年龄和体重指数相匹配的糖尿病前期组相比。
观察到空腹血糖水平与糖尿病患者足底软组织僵硬之间存在关联，且糖尿病患者的剪切波速度值较高。这表明，该方法可以提高对糖尿病足并发症严重程度的评估，具有患者分层的潜在意义。
