Foot muscle energy reserves in diabetic patients without and with clinical peripheral neuropathy.
OBJECTIVE To investigate changes in the foot muscle energy reserves in diabetic non-neuropathic and neuropathic patients. RESEARCH DESIGN AND METHODS We measured the phosphocreatinine (PCr)/inorganic phosphate (Pi) ratio, total (31)P concentration, and the lipid/water ratio in the muscles in the metatarsal head region using MRI spectroscopy in healthy control subjects and non-neuropathic and neuropathic diabetic patients. RESULTS The PCr/Pi ratio was higher in the control subjects (3.23 +/- 0.43) followed by the non-neuropathic group (2.61 +/- 0.36), whereas it was lowest in the neuropathic group (0.60 +/- 1.02) (P < 0.0001). There were no differences in total (31)P concentration and lipid/water ratio between the control and non-neuropathic groups, but both measurements were different in the neuropathic group (P < 0.0001). CONCLUSIONS Resting foot muscle energy reserves are affected before the development of peripheral diabetic neuropathy and are associated with the endothelial dysfunction and inflammation.
Dinh
Thanh
T
Microcirculation Laboratory and Joslin-Beth Israel Deaconess Foot Center, the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Doupis
John
J
Lyons
Thomas E
TE
Kuchibhotla
Sarada
S
Julliard
Walker
W
Gnardellis
Charalambos
C
Rosenblum
Barry I
BI
Wang
Xiaoen
X
Giurini
John M
JM
Greenman
Robert L
RL
Veves
Aristidis
A
D003920:Diabetes Mellitus / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000502:physiology / Q000503:physiopathology; D004734:Energy Metabolism; D005260:Female; D005528:Foot / Q000502:physiology*; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010710:Phosphates / Q000378:metabolism; D010725:Phosphocreatine / Q000378:metabolism; D012016:Reference Values
D010710:Phosphates; D010725:Phosphocreatine