Plantar Tissue Characteristics in People With Diabetes With and Without Peripheral Neuropathy: A Novel Explanatory Model for DPN Risk Assessment

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2025-05-06 DOI:10.1111/1753-0407.70094

Yiming Li, Wei Wu, Liyun Xue, Tianyu Zhao, Yucheng Lu, Xiaohui Qiao, Hong Ding

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引用次数: 0

Abstract

Objectives

Diabetic peripheral neuropathy (DPN) may affect the biomechanical properties and morphology of the plantar tissue. This study aimed to compare plantar stiffness and thickness in individuals with diabetes with and without DPN and develop a novel explanatory model for DPN risk assessment by integrating these measures with clinical parameters.

Materials & Methods

Thirty-two healthy controls and 84 people with diabetes (41 with DPN and 43 without DPN) were included. Shear wave elastography evaluated plantar thickness and stiffness at the heel, hallux, and first and fifth metatarsal heads (1st MTH, 5th MTH). An integrated thickness or stiffness index was generated at multiple locations by principal component analysis (PCA).

Results

People with DPN showed a significant increase in plantar thickness (heel, 1st MTH) (p < 0.001) and stiffness (all tested locations) compared to healthy controls (p < 0.05). Moreover, plantar thickness at 1st MTH, plantar stiffness at 5th MTH, and integrated stiffness index generated by PCA were significantly higher in DPN than in the non-DPN group (p < 0.05). A DPN explanatory model was developed using multivariate logistic regression, incorporating the integrated plantar stiffness index, diabetes duration, and gender. The model showed high discriminative ability (AUROC: 97.7%), with an optimal cutoff of 0.56 yielding 92.7% sensitivity and 95.3% specificity.

Conclusion

The integrated plantar stiffness index, combined with gender and diabetes duration, offers a novel approach for DPN, providing a noninvasive tool for DPN risk assessment.

Abstract Image

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伴有或不伴有周围神经病变的糖尿病患者的足底组织特征：一种新的DPN风险评估解释模型

目的糖尿病周围神经病变（DPN）可能影响足底组织的生物力学特性和形态。本研究旨在比较伴有和不伴有DPN的糖尿病患者的足底硬度和厚度，并通过将这些指标与临床参数相结合，建立一种新的DPN风险评估解释模型。材料,方法选取健康对照32例和糖尿病患者84例（合并DPN 41例，未合并DPN 43例）。剪切波弹性成像评估足跟、拇趾、第一和第五跖骨头（第1 MTH、第5 MTH）的足底厚度和刚度。通过主成分分析（PCA），在多个位置生成综合的厚度或刚度指标。结果与健康对照组相比，DPN患者足底厚度（第1 MTH脚跟）（p < 0.001）和刚度（所有测试部位）显著增加（p < 0.05）。DPN组第1 MTH时足底厚度、第5 MTH时足底刚度、PCA生成的综合刚度指数均显著高于非DPN组（p < 0.05）。采用多元逻辑回归建立了DPN解释模型，纳入了足底僵硬指数、糖尿病持续时间和性别。该模型具有较高的判别能力（AUROC: 97.7%），最佳截断值为0.56，敏感性为92.7%，特异性为95.3%。结论综合足底僵硬指数，结合性别和糖尿病病程，为诊断DPN提供了一种新的方法，为DPN风险评估提供了一种无创工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.