Preliminary Study on the Evaluation of Skeletal Muscle Damage in Patients with Diabetes Mellitus Using Ultrasonic Shear Wave Elastography.

ABSTRACT

Objectives: This study aimed to compare gastrocnemius muscle stiffness levels in subjects with and without type 2 diabetes mellitus (T2DM) using shear wave elastography (SWE). Methods: This is a preliminary study enrolled patients with T2DM and healthy subjects at the affiliated Hospital of Chengdu University of Traditional Chinese Medicine between September 2021 and June 2022. Gastrocnemius muscle stiffness was measured using SWE. Results: A total of 120 individuals (mean age 52.09 ± 5.40 years, 85 males) were enrolled, including 70 patients with T2DM and 50 healthy subjects. There was no significant difference in E at neutral ankle position, plantar flexion position and EBMI at neutral ankle position between T2DM patients and healthy subjects (P > .05). E at upright position (43.89 ± 14.93 vs. 51.71 ± 9.48, P = 0.001), EBMI at plantar flexion position (1.17 (0.82-1.29) vs. 1.55 (1.21-1.84), P < .001) and upright position (1.72 (1.23-2.16) vs. 2.10 (1.88-2.29), P < .001) of the T2DM patients were significantly lower than those of healthy subjects. In T2DM patients, E at upright position was negatively correlated with the disease course (r=-0.645, P < .001), Hemoglobin A1c (HbA1c) concentration (r=-0.741, P < .001), and advanced glycation end-product (AGEs) (r=-0.675, P < .001) but not with age ((r=-0.116, P = .351). Conclusion: SWE results found that active muscle stiffness was significantly lower in T2DM patients compared to healthy controls, suggesting that evaluation of active muscle stiffness using SWE may be valuable in T2DM patients to prevent gastrocnemius muscle damage.