Xu Ji, Cheng Fuming, Dai Ying, Yu Shuting, Chen Wanjun, Zhou Ruhai
Department of Ultrasound Medicine, Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, 315040, People's Republic of China.
Department of Endocrinology and Metabolic Diseases, Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, 315040, People's Republic of China.
Diabetes Metab Syndr Obes. 2024 Nov 25;17:4417-4424. doi: 10.2147/DMSO.S490530. eCollection 2024.
Lipohypertrophy (LH) is a localized complication of type 2 diabetes mellitus in patients on long-term insulin therapy. Sound touch elastography (STE) is a crucial tool in the quantitative real-time assessment of tissue hardness within specific target regions. This study aims to explore the efficacy of STE in evaluating the hardness of subcutaneous LH at insulin injection sites in individuals with type 2 diabetes mellitus and investigate the correlations between the hardness of LH lesions and various clinical indicators.
A cohort of 53 individuals with type 2 diabetes mellitus undergoing insulin therapy at the Department of Endocrinology, Affiliated People's Hospital of Ningbo University from April 2023 to January 2024 was selected. General clinical data of the participants and STE-derived Young's modulus hardness values of the LH lesions and adjacent normal adipose tissue were collected. The Wilcoxon signed-rank test was employed for comparative analysis between the two tissue groups, while Spearman's rank correlation was used to examine the relationships between Young's modulus values of the LH lesions and clinical indicators.
Routine ultrasound examination revealed LH in all 53 participants. The maximum (E), average (E), and minimum (E) values of Young's modulus significantly differed between the LH lesions and surrounding healthy adipose tissue (Z=-6.334, P<0.001; Z=-6.263, P<0.001; Z=-5.865, P<0.001, respectively), indicating greater hardness in the LH lesions. Additionally, the E values of the LH lesions were positively correlated with the glycated hemoglobin levels (r=0.293, P<0.05).
Ultrasound elastography-based STE exhibits great potential in assessing LH hardness in individuals undergoing insulin therapy for type 2 diabetes mellitus. STE offers a novel and objective ultrasonographic approach for accurately evaluating LH severity, highlighting the significance of this technique in clinical diagnostics.
脂肪增生（LH）是长期接受胰岛素治疗的2型糖尿病患者的一种局部并发症。超声剪切波弹性成像（STE）是定量实时评估特定目标区域内组织硬度的关键工具。本研究旨在探讨STE评估2型糖尿病患者胰岛素注射部位皮下LH硬度的有效性，并研究LH病变硬度与各种临床指标之间的相关性。
选取2023年4月至2024年1月在宁波大学附属人民医院内分泌科接受胰岛素治疗的53例2型糖尿病患者。收集参与者的一般临床资料以及LH病变和相邻正常脂肪组织的STE衍生杨氏模量硬度值。采用Wilcoxon符号秩检验对两组组织进行比较分析，同时采用Spearman秩相关分析LH病变杨氏模量值与临床指标之间的关系。
53例参与者的常规超声检查均发现LH。LH病变与周围健康脂肪组织的杨氏模量最大值（E）、平均值（E）和最小值（E）差异有统计学意义（Z分别为-6.334，P<0.001；Z为-6.263，P<0.001；Z为-5.865，P<0.001），表明LH病变硬度更大。此外，LH病变的E值与糖化血红蛋白水平呈正相关（r=0.293，P<0.05）。
基于超声弹性成像的STE在评估接受胰岛素治疗的2型糖尿病患者的LH硬度方面具有巨大潜力。STE为准确评估LH严重程度提供了一种新颖且客观的超声方法，突出了该技术在临床诊断中的重要性。
