Changes Of Foot Muscle And Plantar Tissue Of Patients With Type 2 Diabetes Mellitus Accompanying Peripheral Neuropathy Detected By Hingh-frequency Ultrasongraphy

Objective: To explore the clinical value of high-frequency ultrasonography for the changes of foot muscle and plantar tissue of patients with type 2 diabetes mellitus (T2DM) accompanying diabetic peripheral neuropathy (DPN).Methods: A total of 60 cases of patients with T2DM were enrolled. Then the T2DM patients were distributed into two groups. Thirty cases of patients with type 2 diabetes mellitus accompanying peripheral neuropathy were group DP, Another thirty cases of patients with type 2 diabetes mellitus without peripheral neuropathy were group DM and twenty-five healthy volunteers were divided into group ND. The thickness and the cross-sectional area of the extensor digitorum brevis muscle (EDB), the thickness of the muscle of the first interstitium (MIL), the thickness of the plantar skin (the epidermis and the dermis) and fat (under first to fifth metatarsal bone) of non-dominant foot were measured by using high-frequency ultrasound. Application of t-test and rank sum test for data analysis, the difference with P <0.05 was statistically significant.Results: The thickness and cross-sectional area of the EDB and thickness of the MIL of group DP were significantly reduced comparing with those of group DM and group ND (all P<0.01); The cross-sectional area of the EDB and thickness of the MIL of group DM were significantly reduced comparing with those of group ND (P<0.01). The thickness of the plantar skin under the metatarsal bones of group DP and group DM were all less than those of group ND (all P<0.05). The thickness of the plantar fat of group DP and of group DM were all less than those of group ND (all P <0.05); The thickness of the plantar fat of group DP were less than those of group DM (all P <0.05).Conclusion: The atrophy of foot muscle and the attenuation of the plantar skin and fat of patients with type 2 diabetes mellitus could be detected by high-frequency ultrasonography. The results showed that the atrophy of foot muscle and the attenuation of the plantar fat of patients with type 2 diabetes mellitus accompanying peripheral neuropathy were more reduction. The atrophy of foot muscles and the attenuation of plantar tissue of patients with type 2 diabetes mellitus with or without peripheral neuropathy can be evaluated by High-frequency ultrasound objectively.