The Clinical Significance Of Abnormalities Achilles Tendon In Patients With Type 2 Diabetes Mellitus Were Detected By High-frequency Ultrasonography And MicroPure Technology

OBJECTIVE: To explore the clinical significance of the ultmsonographic features of achilles tendon(AT)of diabetic patients by combining the high frequency ultrasound(HFUS)with Micro Pure technology.METHODS: 83 cases of type 2 diabetic patients were enrolled and according to the patients with or without occurrence of diabetic foot(DF),they were divided into two groups: DF group and type 2 diabetes mellitus(T2DM)group.30 healthy subjects were enrolled as normal control.The characteristics of AT and it's micro-calcifications were detected by the HFUS and Micro Pure technology.The bilateral AT's width and thickness of the 3 groups and the correlations between the AT's width and thickness were analysed with the glycosylated hemoglobin(HBA1c).RESULTS: Significant distinctions of Fasting blood glucose(FG),systolic pressure(SP),uric acid(UA)and HBA1 c between the three groups(P<0.05)were observed.The thickness of origin point(left: 5.83±0.67 VS 5.12±0.64 VS4.79±0.69,P<0.01;right: 5.71±0.63 VS 5.19±0.62 VS5.00±0.63,P<0.01),middle point(left: 5.78±0.65 VS 4.97±0.77 VS 4.86±0.52,P<0.01;right: 5.84±0.76 VS 5.17±0.68 VS 4.91±0.60,P<0.01)and the end point(left:5.67±0.69 VS 4.93±0.70 VS 4.75±0.81,P<0.01;right: 5.82±0.73 VS5.26±0.53 VS 5.15±0.96,P<0.01)of both bilateral AT of DF group and T2 DM group were all higher than that of normal control.However,only the origin point(left: 15.52±1.15 VS 14.42±1.32 VS13.79±1.32,P<0.01;right : 15.63±1.14 VS 14.73±1.38 VS 13.94±1.03,P<0.01)and middle point(left: 17.23±1.59 VS16.55±1.56 VS16.11±1.42,P<0.01;right: 17.11±1.63 VS 16.62±1.38 VS 15.86±1.06,P=0.01)of AT were wider than normal control.Patients with DF and T2 DM groups had a higher prevalence of abnormal echogenicity,bursitis,enthesophyte or bony erosion(all P < 0.01).The number of micro-calcifications of AT of DF and T2 DM groups were both greater than the normal control(P<0.05).Moreover,there were a positive correlation between the glycosylated hemoglobin and most bilateral AT's width and thickness(P<0.05).CONCLUSIONS: There is an elevated prevalence of asymptomatic AT enthesopathic changes in T2 DM patients,especially in DF patients.These changes might help to provide important imaging evidence for the occurrence of DF.