Bozkuş Rıfat, Süer Doğan İhsaniye, Turhan Berna, Duran Kaymak Sümeyya, Kurt Mustafa Hulusi, Kavak Rasime Pelin
Department of Internal Medicine, Ankara Etlik City Hospital, Ankara, Turkiye.
Department of Radiology, Ankara Etlik City Hospital, Ankara, Turkiye.
Turk J Med Sci. 2025 Jun 23;55(4):893-903. doi: 10.55730/1300-0144.6042. eCollection 2025.
BACKGROUND/AIM: The primary aim of this study was to compare the thickness and stiffness of the plantar fascia (PF) and Achilles tendon (AT) between healthy volunteers and patients with type 2 diabetes mellitus (T2DM). A secondary objective was to explore the correlations between the thickness and stiffness of the PF and AT and diabetes duration (in months) and hemoglobin A1c (HbA1c) levels in T2DM patients without peripheral neuropathy or foot ulcers, with peripheral neuropathy, or with foot ulcers.
A total of 289 participants, including 117 healthy volunteers (Group A) and 172 T2DM patients (59.5%), matched for age, sex, and body mass index, were included. The T2DM cohort was stratified into three subgroups: Group B (without peripheral neuropathy or foot ulcers), Group C (with peripheral neuropathy), and Group D (with foot ulcers). Ultrasonography (USG) and shear wave elastography (SWE) were used to assess PF and AT properties, and correlations with diabetes duration and HbA1c levels were analyzed.
T2DM patients exhibited significantly greater PF and AT thickness, and lower stiffness compared to healthy controls (p < 0.001). Among subgroups, Group D had the greatest PF and AT thickness and the lowest stiffness, followed by Group C and then Group B (p < 0.001 for all comparisons). Positive correlations were observed between diabetes duration, HbA1c levels, and tendon thickness, while negative correlations were identified with stiffness (p < 0.001 for all).
USG and SWE revealed significant alterations in PF and AT properties in T2DM patients compared to healthy individuals, with these changes correlating with diabetes severity and duration.
背景/目的：本研究的主要目的是比较健康志愿者与2型糖尿病（T2DM）患者足底筋膜（PF）和跟腱（AT）的厚度及硬度。次要目的是探讨无周围神经病变或足部溃疡、有周围神经病变或有足部溃疡的T2DM患者中，PF和AT的厚度及硬度与糖尿病病程（以月为单位）及糖化血红蛋白（HbA1c）水平之间的相关性。
共纳入289名参与者，包括117名健康志愿者（A组）和172名T2DM患者（59.5%），这些参与者在年龄、性别和体重指数方面相匹配。T2DM队列被分为三个亚组：B组（无周围神经病变或足部溃疡）、C组（有周围神经病变）和D组（有足部溃疡）。采用超声检查（USG）和剪切波弹性成像（SWE）评估PF和AT的特性，并分析其与糖尿病病程和HbA1c水平的相关性。
与健康对照组相比，T2DM患者的PF和AT厚度显著更大，硬度更低（p < 0.001）。在各亚组中，D组的PF和AT厚度最大，硬度最低，其次是C组和B组（所有比较p < 0.001）。观察到糖尿病病程、HbA1c水平与肌腱厚度呈正相关，而与硬度呈负相关（所有p < 0.001）。
与健康个体相比，USG和SWE显示T2DM患者的PF和AT特性有显著改变，这些变化与糖尿病严重程度和病程相关。
