Roozbeh Naemi1, Stefano E Romero Gutierrez2, David Allan1, Gilmer Flores2, Juvenal Ormaechea2,3, Evelyn Gutierrez2, Jessica Casado-Pena4, Sharon Anyosa-Zavaleta5, Mauricio Juarez2, Fanny Casado2, Benjamin Castaneda Aphan2. 1. Centre for Biomechanics and Rehabilitation Technologies, School of Life Sciences and Education, Staffordshire University, Staffordshire, UK. 2. Department of Engineering, Medical Imaging Laboratory, Pontificia Universidad Catolica del Peru, Lima, Peru. 3. Department of Electrical and Computer Engineering, University of Rochester, New York, USA. 4. Day Hospital Unit, Hospital Militar Geriatrico, Lima, Peru. 5. Translational Unit, Institute of Omics and Applied Biotechnology, Pontificia Universidad Catolica del Peru, Lima, Peru.
Abstract
INTRODUCTION: The purpose of this study was to investigate the association between the mechanical properties of plantar soft tissue and diabetes status. METHOD: 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. RESULTS: Spearman's rank-order correlation (rho) test indicated a significant (P < .05) positive correlations between FBS level and the plantar soft tissue shear wave speed at the 1st MTH: rho = 0.402 (@400 Hz), rho = 0.373 (@450 Hz), rho = 0.474 (@500 Hz), rho= 0.395 (@550 Hz), and rho = 0.326 (@600 Hz) in the left foot and rho = 0.364 (@450 Hz) in the right foot. Mann-Whitney U test indicated a significantly (P < .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: r = 0.297 (@450 Hz), r = 0.345 (@500 Hz), r = 0.322 (@550 Hz), and r = 0.275 (@600 Hz), and at the 1st MTH of right foot r = 0.286 (@400 Hz) in diabetes as compared with the age and body mass index matched prediabetes group. CONCLUSION: 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.
INTRODUCTION: The purpose of this study was to investigate the association between the mechanical properties of plantar soft tissue and diabetes status. METHOD: 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. RESULTS: Spearman's rank-order correlation (rho) test indicated a significant (P < .05) positive correlations between FBS level and the plantar soft tissue shear wave speed at the 1st MTH: rho = 0.402 (@400 Hz), rho = 0.373 (@450 Hz), rho = 0.474 (@500 Hz), rho= 0.395 (@550 Hz), and rho = 0.326 (@600 Hz) in the left foot and rho = 0.364 (@450 Hz) in the right foot. Mann-Whitney U test indicated a significantly (P < .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: r = 0.297 (@450 Hz), r = 0.345 (@500 Hz), r = 0.322 (@550 Hz), and r = 0.275 (@600 Hz), and at the 1st MTH of right foot r = 0.286 (@400 Hz) in diabetes as compared with the age and body mass index matched prediabetes group. CONCLUSION: 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.
Authors: R Naemi; P Chatzistergos; S Suresh; L Sundar; N Chockalingam; A Ramachandran Journal: Diabetes Res Clin Pract Date: 2017-02-10 Impact factor: 5.602
Authors: Laura R Loehr; Michelle L Meyer; Anna K Poon; Elizabeth Selvin; Priya Palta; Hirofumi Tanaka; James S Pankow; Jacqueline D Wright; Michael E Griswold; Lynne E Wagenknecht; Gerardo Heiss Journal: Am J Hypertens Date: 2016-04-11 Impact factor: 2.689
Authors: Ben M Sörensen; Alfons J H M Houben; Tos T J M Berendschot; Jan S A G Schouten; Abraham A Kroon; Carla J H van der Kallen; Ronald M A Henry; Annemarie Koster; Simone J S Sep; Pieter C Dagnelie; Nicolaas C Schaper; Miranda T Schram; Coen D A Stehouwer Journal: Circulation Date: 2016-09-27 Impact factor: 29.690