2015
Achilles tendons in people with type 2 diabetes show mildly compromised structure: An ultrasound tissue characterisation study
Publication
Publication
British Journal of Sports Medicine: an international peer-reviewed journal of sport and exercise medicine , Volume 49 - Issue 15 p. 995- 999
ABSTRACT
Background Musculotendinous overuse injuries are
prevalent in people with type 2 diabetes. Non-enzymatic
glycosylation of collagen resulting in tendon stiffening
may play a role. In this case–control study we
determined whether patients with diabetes had poorer
ultrasonographic structure in their Achilles tendons
compared to age-matched controls.
Methods People with type 1 diabetes or type 2 diabetes, and age-matched controls, had computerised ultrasound tissue characterisation of both Achilles tendons. In contiguous ultrasonographic images of the tendon, echopatterns were quantified and categorised into four echo-types. Tendon abnormality was quantified as sum of echo-types III+IV. Furthermore, skin autofluorescence (AF) of the forearm (AF-value) was gathered.
Results Twenty four type 2 diabetes patients, 24 controls, 24 type 1 diabetes patients and 20 controls were included. AF-value was higher in type 1 diabetes (1.55±0.17) than in their controls (1.39±0.18, p<0.001) and in type 2 diabetes (2.28±0.38) compared to their controls (1.84±0.32, p<0.001) Achilles tendons of type 2 diabetes patients contained more echo-types III +IV (14.1±7.9%) than matched controls (8.0±5.4%, p<0.001). There was a trend towards a difference in echo-types III+IV between type 1 diabetes patients (9.5 ±5.3%) and their controls (6.5±3.7%, p=0.055). In a stepwise linear regression analysis, body mass index (BMI) was moderately associated with tendon abnormality in patients with diabetes and controls (β=0.393, p<0.001).
Conclusions Type 2, and possibly type 1, diabetes patients showed poorer ultrasonographic Achilles tendon structure that may be a risk factor for tendinopathy. Although markers for accumulation of advanced glycation end products were elevated in both diabetes populations, only BMI was associated with these abnormalities.
Trial registration number NTR2209.
Additional Metadata | |
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doi.org/10.1136/bjsports-2014-093696, hdl.handle.net/1765/79627 | |
British Journal of Sports Medicine: an international peer-reviewed journal of sport and exercise medicine | |
Organisation | Department of Orthopaedics |
de Jonge, S., Rozenberg, R., Vieyra, B., Stam, H., Aanstoot, H.-J., Weinans, H., … Praet, S. (2015). Achilles tendons in people with type 2 diabetes show mildly compromised structure: An ultrasound tissue characterisation study. British Journal of Sports Medicine: an international peer-reviewed journal of sport and exercise medicine, 49(15), 995–999. doi:10.1136/bjsports-2014-093696 |