Background. Patients with diabetes have 44% greater risk of tendon rupture requiring hospitalisation. Despite this, in vivo research of the associations of diabetes and other cardiovascular disease risk factors on structural and mechanical properties of the Achilles tendon are sparsely studied.
Methods. Inactive individuals with type 2 diabetes (n=33) underwent ultrasound and shear wave elastography imaging of their Achilles tendons bilaterally to measure thickness and shear wave velocity (SWV), an index of tendon elastic modulus. In a separate session, participants underwent assessment of body composition, cardiorespiratory fitness and blood biomarkers. Seven inactive individuals without type 2 diabetes were recruited for comparison of tendon structural and mechanical properties.
Results. In participants with diabetes, free tendon SWV displayed large negative correlations with hip circumference (r=-0.67, P <0.001), waist circumference (r=-0.59, P <0.001) and body mass index (r=-0.52, P <0001), and a moderate positive correlation with VO2peak (r=0.34, P =0.006). SWV was lower in participants with diabetes taking statins compared to not taking statins (Free tendon: median difference 8%, P=0.004); insertion: 11%, P =0.001). Compared to the control group, the diabetes group had thicker Achilles free tendon (median difference 15%, P<0.001) and Achilles insertion (17%, P=0.006), but no differences in SWV (P=0.490 or 0.577 respectively).
Conclusions. Achilles tendons from individuals with type 2 diabetes were thicker compared to inactive individuals without diabetes. Adiposity, statin use and low cardiorespiratory fitness were associated with inferior Achilles tendon mechanical properties in people with diabetes.
Relationships between cardiovascular disease risk factors and Achilles tendon structural and mechanical properties in people with Type 2 Diabetes
B.K. Coombes, K. Tucker, F. Hug, A. Scott, M. Geytenbeek, E.R. Cox, T. Gajanand, J.S. Coombes
Original Article, 395-404
Keywords: adiposity, elastic modulus, enthesis, lipids, stiffness, tendinopathy,
Table of Content: Vol.9 (No.3) 2019 July/September
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