Evaluation Of Rectus Abdominis Stiffness In Patients With Diabetes Mellitus By Shear Wave Young’s Modulus And Analysis Of Its Related Factors

ObjectiveThe aim of the present study was to compare the difference of Young’s modulus of rectus abdominis（RA）between diabetic patients and normal controls by utilizing shear wave elastography（SWE）and then to explore the relevant clinical factors affecting Young’s modulus of rectus abdominis in patients with diabetes so as to provide imaging basis for early intervention and prevention of diabetic myopathy.MethodsA total of 32 patients with diabetes who were hospitalized in Endocrinology and 31 age-,gender-,and BMI-matched normal controls were included from August 2020 to December 2020.The general information such as height,weight,body mass index and the results of blood biochemical examination such as fasting blood glucose（FPG）,glycosylated hemoglobin（Hb A1c）,creatine enzyme（CK）were collected in both groups.The thicknesses of rectus abdominis of all participants were measured by high frequency ultrasound and the average Young’s modulus(E_mean)of rectus abdominis in the resting state was measured by SWE technique.Besides,Color doppler ultrasound（CDFI）was performed to measure the internal diameter,peak systolic velocity（PSV）and resistance index（RI）at the beginning of the inferior epigastric artery（IEA）which is one of the blood supply arteries of the rectus abdominis.Data were statistically analyzed with SPSS version 22.0 software.The deferences of general information and results of blood biochemical examination between the two groups were compared by independent sample t-test.Univariable linear regression was performed to screen relevant clinical factors that may affect Young’s modulus and then multivariable linear regression was applied to determine the independent influencing factors.P value<0.05 was considered that the deference was statistically significant.Results1.SWE results demonstrated significantly decreased in the average Young’s modulus of rectus abdominis in relaxed status in those with diabetes compared to controls（P<0.05）,whereas no statistically significant differences in the thicknesses of rectus abdominis and hemodynamic parameters of inferior epigastric artery（P<0.05）.2.The average Young’s modulus of rectus abdominis in diabetic patients was correlated with the imaging section,and the average Young’s modulus in the longitudinal section is significantly higher than that in the transverse section（P<0.05）.3.Age and BMI were negatively correlated with the average Young’s modulus of rectus abdominis in diabetic patients and both of them were independent risk factors of Young’s modulus（P<0.05）.Conclusion1.There is a decrease in the stiffness of rectus abdominis muscle in patients with diabetes.2.The selection of imaging section should be considered when using shear wave elastography to measure the elasticity of skeletal muscle tissue.3.Age and BMI are independent risk factors for the decrease of rectus abdominis muscle stiffness in patients with diabetes.4.SWE technique can be used to evaluate the changes of muscle stiffness in patients with diabetes.