Human Achilles tendon glycation and function in diabetes
Human Achilles tendon glycation and function in diabetes
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DOI：
10.1152/japplphysiol.00547.2015
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发表时间：
2016-01-15
影响因子：
3.3
通讯作者：
Magnusson, Stig Peter
中科院分区：
文献类型：
--
作者：
Couppe, Christian;Svensson, Rene Bruggebusch;Magnusson, Stig Peter
糖尿病患者患足部溃疡的风险增加，胶原蛋白的糖化可能会增加组织硬度。我们假设血糖控制水平（糖化）可能会影响跟腱僵硬度，从而影响步态模式。因此，我们研究了控制不佳（n = 22）和控制良好（n = 22）的糖尿病患者（包括健康年龄匹配（45-70岁）对照组（n = 11））中胶原蛋白糖化、跟腱僵硬参数和足底压力之间的关系。糖尿病控制良好和控制不佳的患者之间的任何结果参数（胶原交联或肌腱硬度）没有差异。通过与对照组相比，折叠糖尿病组（DB）来探索糖尿病的总体影响。皮肤胶原交联赖氨酰吡啶啉、羟赖氨酰吡啶啉（136%，80%，P < 0.01）和戊糖苷（55%，P < 0.05）含量明显高于对照组。DB组跟腱材料刚度高于DB组（54%，P < 0.01）。值得注意的是，DB还表现出更高的前足/后足峰值足底压力比（33%，P < 0.01）。总的来说，糖尿病患者的跟腱材料硬度和皮肤结缔组织交联程度高于对照组。较高的足部压力表明肌腱和其他组织（例如，皮肤和关节囊）可能影响足部步态。足部压力分布的差异可能有助于糖尿病患者足部溃疡的发展。
Diabetic patients have an increased risk of foot ulcers, and glycation of collagen may increase tissue stiffness. We hypothesized that the level of glycemic control (glycation) may affect Achilles tendon stiffness, which can influence gait pattern. We therefore investigated the relationship between collagen glycation, Achilles tendon stiffness parameters, and plantar pressure in poorly (n = 22) and well (n = 22) controlled diabetic patients, including healthy age-matched (45-70 yr) controls (n = 11). There were no differences in any of the outcome parameters (collagen cross-linking or tendon stiffness) between patients with well-controlled and poorly controlled diabetes. The overall effect of diabetes was explored by collapsing the diabetes groups (DB) compared with the controls. Skin collagen cross-linking lysylpyridinoline, hydroxylysylpyridinoline (136%, 80%, P < 0.01) and pentosidine concentrations (55%, P < 0.05) were markedly greater in DB. Furthermore, Achilles tendon material stiffness was higher in DB (54%, P < 0.01). Notably, DB also demonstrated higher forefoot/rearfoot peak-plantar-pressure ratio (33%, P < 0.01). Overall, Achilles tendon material stiffness and skin connective tissue cross-linking were greater in diabetic patients compared with controls. The higher foot pressure indicates that material stiffness of tendon and other tissue (e.g., skin and joint capsule) may influence foot gait. The difference in foot pressure distribution may contribute to the development of foot ulcers in diabetic patients.