The compressive, shear, biochemical, and histological characteristics of diabetic and non-diabetic plantar skin are minimally different.
The compressive, shear, biochemical, and histological characteristics of diabetic and non-diabetic plantar skin are minimally different.
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糖尿病和非糖尿病足底皮肤的压缩、剪切、生物化学和组织学特征差异极小。
DOI：
10.1016/j.jbiomech.2021.110797
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发表时间：
2021-12-02
影响因子：
2.4
通讯作者：
Ledoux WR
中科院分区：
文献类型：
--
作者：
Brady L;Pai S;Iaquinto JM;Wang YN;Ledoux WR
糖尿病与下肢合并症有关，包括溃疡和随后的截肢。作为一种全身性疾病，糖尿病影响软组织的微观结构，并且已知材料微观结构变化会影响宏观力学。然而，糖尿病相关的破坏与糖尿病足底皮肤的基本微结构成分和机械变化之间的关联尚未得到充分的表征。足底皮肤标本采集自4名糖尿病患者和8名非糖尿病患者的6个足底位置（拇趾;第一、第三和第五跖骨;外侧中足;跟骨）。对一只脚的新鲜冷冻标本进行力学测试，对另一只脚的标本进行组织形态学测量和生化定量。机械（压缩和剪切模量和粘弹性斜率）和生化/组织学（胶原蛋白和弹性蛋白的总量;真皮和表皮厚度）参数相关使用线性混合效应回归。不同疾病状态之间没有显着差异。皮肤厚度与初始压缩模量和所有三个剪切模量呈正相关。第三跖骨的最终压缩模量显著低于第五跖骨、外侧中足和跟骨，而跟骨的最终剪切模量显著高于拇趾、第一和第三跖骨。与所有其他位置相比，跟骨处的表皮厚度显著更高。虽然疾病状态的差异不显著，但位置的强烈差异以及皮肤厚度和力学之间的显著但微弱的相关性可以为未来的研究提供信息，以了解糖尿病足溃疡形成的机制。
Diabetes is associated with lower limb co-morbidities, including ulceration and subsequent amputation. As a systemic disease, diabetes affects the microstructure of soft tissues, and material microstructural changes are known to affect the macroscale mechanics. However, the associations between diabetes-related disruptions to essential microstructural components and mechanical changes in plantar skin with diabetes has not been thoroughly characterized. Plantar skin specimens were collected from four diabetic and eight non-diabetic donors at six plantar locations (hallux; first, third, and fifth metatarsals; lateral midfoot; calcaneus) from matched pairs. Mechanical testing was performed on fresh frozen specimens from one foot, and histomorphological measurement and biochemical quantification were performed on specimens from the other foot. Mechanical (compressive and shear moduli and viscoelastic slopes) and biochemical/histological (total quantity of collagen and elastin; dermal and epidermal thickness) parameters were correlated using linear mixed effects regression. There were no significant differences by disease state. Skin thicknesses were positively correlated with initial compression modulus and all three shear moduli. The final compressive modulus was significantly lower at the third metatarsal than the fifth metatarsal, lateral midfoot, and calcaneus, while the final shear modulus was significantly higher at the calcaneus than at the hallux, first, and third metatarsals. Epidermal thickness was significantly higher at the calcaneus compared to all other locations. While differences were not significant by disease state, the strong differences by locations and significant but weak correlations between skin thickness and mechanics can inform future research to understand the mechanism of ulcer formation in the diabetic foot.
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DOI：
10.1530/acta.0.0980432
发表时间：
1981-01-01
期刊：
ACTA ENDOCRINOLOGICA
影响因子：
--
作者：
ANDREASSEN, TT;SEYERHANSEN, K;OXLUND, H
通讯作者：
OXLUND, H
影响因子：
1.8
作者：
Hsu, Chih-Chin;Tsai, Wen-Chung;Lin, Shih-Chieh
通讯作者：
Lin, Shih-Chieh
影响因子：
2.9
作者：
Chao, Clare Y. L.;Zheng, Yong-Ping;Cheing, Gladys L. Y.
通讯作者：
Cheing, Gladys L. Y.
影响因子：
2.9
作者：
Hsu, CC;Tsai, WC;Chang, KJ
通讯作者：
Chang, KJ
影响因子：
2.4
作者：
Ledoux, William R.;Pai, Shruti;Wang, Yak-Nam
通讯作者：
Wang, Yak-Nam