Detection Of Atrophy Of Foot Muscles In Patients Of Type2Diabetes Mellitus With Diabetic Periphery Neuropathy By High-Frequency Ultrasonography

Objective：To evaluate the diagnostic value of ultrasonography in detectingatrophy of foot muscles in patients of type2diabetes (T2DM) with or without diabeticperiphery neuropathy (DPN).Methods：During November2011to May2012,106T2DM inpatients at theDepartment of Endocrinology of the Second Affiliated Hospital of Dalian MedicalCollege were enrolled. By using the Michigan Neuropathy Screening Instrument andnerve electrophysiological examination, the T2DM patients were devided into twogroups: group A (T2DM with DPN,56cases, male30, female26, age44~77yr,average age62.6±6.7yr); group B (T2DM without DPN,50cases, male26, female24,age38~78yr, average age58.8±10.0yr), and50healthy subjects were enrolled as thegroup C of the control (50cases, male25, female25, age49~78yr, average age59.3±7.3yr). The nondominat foot of all patients and control subjects were examinedwith high-frequency ultrasonography (GE LOGIQ E9from USA，high-frequency linearmode,9-15MHz). The transverse diameter, thickness and cross-sectional area of theextensor digitorum brevis muscle (EDB) and thickness of the muscles of the firstinterstitium (MIL) were measured. Data were presented as x±s, and variablecoefficient (CV=s/x×100%) was used to assess the reproducibility of measurement inthe control group. One-way analysis of variance was used to analyze the multiple means,LSD was used to compare the differences between groups. P <0.05was considered assignificantly different.Results：Transverse diameter, thickness and cross-sectional area of the EDB andthickness of MIL in group A were significantly smaller than those in group C (allP<0.01); Transverse diameter and cross-sectional area of the EDB and thickness of MILin group B were significantly smaller than those in group C (all P<0.01); Transverse diameter, thickness and cross-sectional area of the EDB and thickness of MIL in groupA were significantly smaller than those in group B (all P<0.01). The cross-sectionalarea of the EDB was shown to be decreased the most among the indices. All CVs of thecontrol group were below4%.Conclusion： The structure of the foot muscles can be shown clearly byhigh-frequency ultrasonography and the reproducible measurements of the muscles canbe made. The atrophy of foot muscles including the EDB and MIL in T2DM patientswith or without DPN can be detected by high-frequency ultrasonography. The atrophyof foot muscles worsens in T2DM patients with DPN. The cross-sectional area of theEDB is shown to be decreased the most. The atrophy of foot muscle in T2DM patientswith or without DPN can be detected by high-frequency ultrasonography objectively.