Foot Muscle Energy Reserves in Diabetic Patients Without and With Clinical Peripheral Neuropathy
- Thanh Dinh, DPM1,
- John Doupis, MD1,
- Thomas E. Lyons, DPM1,
- Sarada Kuchibhotla, MS1,
- Walker Julliard, MS1,
- Charalambos Gnardellis, PHD2,
- Barry I. Rosenblum, DPM1,
- Xiaoen Wang, MD3,
- John M. Giurini, DPM1,
- Robert L. Greenman, PHD3 and
- Aristidis Veves, MD1
- 1Microcirculation Laboratory and Joslin–Beth Israel Deaconess Foot Center, the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts;
- 2Technological Educational Institute of Messolonghi, Messolonghi, Greece;
- 3Department of Radiology, the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
- Corresponding author: Aristidis Veves, aveves{at}bidmc.harvard.edu.
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 31P 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 31P 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.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received March 18, 2009.
- Accepted April 28, 2009.
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Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
- © 2009 by the American Diabetes Association.
