Plantar tissue thickness is related to peak plantar pressure in the high-risk diabetic foot
Plantar tissue thickness is related to peak plantar pressure in the high-risk diabetic foot
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DOI：
10.2337/diacare.24.7.1270
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发表时间：
2001-07-01
期刊：
影响因子：
16.2
通讯作者：
Boulton, AJM
中科院分区：
文献类型：
--
作者：
Abouaesha, F;van Schie, CHM;Boulton, AJM
目的-研究足底压力，足底皮下组织厚度，神经病变的严重程度（振动感知阈值[VPT]），胼胝体，和BMI之间的关系在一大群神经病变糖尿病患者的风险foot ulceration.Research设计和方法-共157糖尿病神经病变患者（VPT > 25 V）没有任何周围血管或溃疡的历史进行了研究。足底足底压力和足底组织厚度分别测量在每个跖骨头（MTH）使用光学pedobarograph和超声扫描platforms.RESULTS-一个显着的协会之间观察到的峰值足底压力和足底组织厚度在所有MTH（-0.26 < r <-0.61，P < 0.0001），与最不明显的关联在第一个MTH。压力积分与足底组织厚度呈显著正相关（-0.24 < r <-0.57，P < 0.0001）。BMI与足底组织厚度显著相关（0.18 < r < 0.45，P < 0.05），但与前足峰值压力无关。除第一次MTH外，所有MTHs的胼胝体受试者的足底组织厚度均显著降低，所有MTHs的峰值压力均增加（P < 0.001）。对该患者人群的长期随访将证实足底组织厚度的减少是否预示糖尿病足溃疡的发展。
OBJECTIVE - To investigate the relationship among plantar foot pressure, plantar subcutaneous tissue thickness, severity of neuropathy (vibration perception threshold [VPT]), callus, and BMI in a large group of neuropathic diabetic patients at risk of foot ulceration.RESEARCH DESIGN AND METHODS - A total of 157 diabetic neuropathic patients (VPT > 25 V) without either peripheral vascular or ulcer history were studied. Plantar foot pressure and plantar tissue thickness were measured at each metatarsal head (MTH) using an optical pedobarograph and an ultrasound scanning platform, respectively.RESULTS- A significant association was observed between peak plantar pressure and plantar tissue thickness at all MTHs (-0.26 < r < -0.61, P < 0.0001), with the least pronounced association at the first MTH. In addition, the pressure lime integral was significantly associated with plantar tissue thickness (-0.24 < r < -0.57, P < 0.0001). BMI was significantly related to plantar tissue thickness (0.18 < r < 0.45, P < 0.05), but not to peak forefoot pressures. Subjects with callus had significantly reduced plantar tissue thickness at all MTHs except the first MTH and increased peak pressures at all MTHs (P < 0.001).CONCLUSIONS - This study confirms a strong inverse relationship between plantar tissue thickness and dynamic foot pressure measurements. Long-term follow-up of this patient population will confirm whether reduced plantar tissue thickness predicts the development of diabetic foot ulcers.