Afolabi Babalola Ishamel, Idowu Bukunmi Michael, Onigbinde Stephen Olaoluwa
Department of Radiology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
Department of Radiology, Union Diagnostics and Clinic Services Plc, Yaba, Lagos, Nigeria.
J Ultrason. 2021;20(83):e291-e299. doi: 10.15557/JoU.2020.0051. Epub 2020 Dec 18.
The main goal of this study was to compare the various degenerative changes in the Achilles tendon of type 2 diabetic patients to that of controls. The influence of diabetic peripheral neuropathy, duration of diabetes mellitus, age, and body mass index on the occurrence of degenerative changes was also evaluated.
The Achilles tendons of both limbs were evaluated with high-resolution ultrasound in 80 type 2 diabetics and 80 age/sex-matched controls. A 10 g Semmes Weinstein monofilament was used to examine for peripheral neuropathy. Anthropometric measurements and biochemical assessment of glycemic control (fasting plasma glucose and glycated hemoglobin) were also done.
The mean age of type 2 diabetic subjects and healthy controls was 60.9 ± 10.3 years (range 41-79 years) and 61.0 ± 10.3 years (range 40-79 years), respectively ( = 0.963). The median duration of diabetes mellitus was 42.0 months (range = 1-456 months). The prevalence of degenerative changes (calcifications, disorganized fibers and/or hypoechoic foci) was significantly higher in type 2 diabetic subjects than controls in both the right (55.0% 18.8%, <0.001) and left (52.5% 18.8%, <0.001) feet.
The Achilles tendons of type 2 diabetic subjects have significantly more degenerative changes than their age/ sex-matched controls in our locality. Disorganized Achilles tendon fibers occur significantly more often among male than female type 2 diabetic subjects. Disorganization of Achilles tendon fibers and hypoechoic foci are significantly more prevalent in type 2 diabetic subjects with peripheral neuropathy than those without peripheral neuropathy. Body mass index did not affect the occurrence of degenerative changes in the Achilles tendon of participants.
本研究的主要目标是比较2型糖尿病患者与对照组跟腱的各种退行性变化。还评估了糖尿病周围神经病变、糖尿病病程、年龄和体重指数对退行性变化发生的影响。
对80例2型糖尿病患者和80例年龄/性别匹配的对照组的双下肢跟腱进行高分辨率超声检查。使用10g Semmes Weinstein单丝检查周围神经病变。还进行了人体测量和血糖控制的生化评估（空腹血糖和糖化血红蛋白）。
2型糖尿病患者和健康对照组的平均年龄分别为60.9±10.3岁（范围41 - 79岁）和61.0±10.3岁（范围40 - 79岁）（P = 0.963）。糖尿病的中位病程为42.0个月（范围 = 1 - 456个月）。2型糖尿病患者双侧足部（右侧55.0% 对18.8%，P<0.001；左侧52.5% 对18.8%，P<0.001）退行性变化（钙化、纤维紊乱和/或低回声灶）的患病率显著高于对照组。
在我们当地，2型糖尿病患者的跟腱比年龄/性别匹配的对照组有明显更多的退行性变化。2型糖尿病男性患者跟腱纤维紊乱的发生率明显高于女性。2型糖尿病合并周围神经病变患者跟腱纤维紊乱和低回声灶的患病率明显高于无周围神经病变者。体重指数未影响参与者跟腱退行性变化的发生。
