Foot Muscle Energy Reserves In Diabetic Patients Without And With Clinical Peripheral Neuropathy
- Thanh Dinh, DPM,
- John Doupis, MD,
- Thomas E. Lyons, DPM,
- Sarada Kuchibhotla, MS,
- Walker Julliard, MS,
- Charalambos Gnardellis, PhD,
- Barry I Rosenblum, DPM,
- Xiaoen Wang, MD,
- John M. Giurini, DPM,
- Robert L. Greenman, PhD and
- Aristidis Veves, MD (aveves{at}bidmc.harvard.edu)
- Microcirculation Laboratory and Joslin-Beth Israel Deaconess Foot Center (TD, JD, TEL, SK, WJ, BIR, JMG, AV), and the Department of Radiology (RLG, XW), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston MA and Technological Educational Institute of Messolonghi, Greece (CG)
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/inorganic phosphate (PCr/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 controls (3.23 ± 0.43) followed by the non-neuropathic group (2.61 ± 0.36) while 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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- Received March 18, 2009.
- Accepted April 28, 2009.
- Copyright © American Diabetes Association
