title: Foot muscle energy reserves in diabetic patients without and with clinical peripheral neuropathy.
abstract: 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.
authors.affiliation: Microcirculation Laboratory and Joslin-Beth Israel Deaconess Foot Center, the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Thanh
authors.initials: T
authors.lastname: Dinh
authors.forename: John
authors.initials: J
authors.lastname: Doupis
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Lyons
authors.forename: Sarada
authors.initials: S
authors.lastname: Kuchibhotla
authors.forename: Walker
authors.initials: W
authors.lastname: Julliard
authors.forename: Charalambos
authors.initials: C
authors.lastname: Gnardellis
authors.forename: Barry I
authors.initials: BI
authors.lastname: Rosenblum
authors.forename: Xiaoen
authors.initials: X
authors.lastname: Wang
authors.forename: John M
authors.initials: JM
authors.lastname: Giurini
authors.forename: Robert L
authors.initials: RL
authors.lastname: Greenman
authors.forename: Aristidis
authors.initials: A
authors.lastname: Veves
mesh_terms: 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
chemical_list: D010710:Phosphates; D010725:Phosphocreatine