scholarly journals The Mechanoreceptor’s Role in Plantar Skin Changes in Individuals with Diabetes Mellitus

2021 ◽  
Vol 10 (12) ◽  
pp. 2537
Author(s):  
Claudio Zippenfennig ◽  
Tina J. Drechsel ◽  
Renan L. Monteiro ◽  
Isabel C. N. Sacco ◽  
Thomas L. Milani

Mechanical skin properties (MSPs) and vibration perception thresholds (VPTs) show no relationship in healthy subjects. Similar results were expected when comparing MSP and VPT in individuals with diabetes mellitus (DM) and with diabetic (peripheral-)neuropathy (DPN). A healthy control group (33 CG), 20 DM and 13 DPN participated in this cross-sectional study. DM and DPN were classified by using a fuzzy decision support system. VPTs (in µm) were measured with a modified vibration exciter at two different frequencies (30 and 200 Hz) and locations (heel, first metatarsal head). Skin hardness (durometer readings) and thickness (ultrasound) were measured at the same locations. DPN showed the highest VPTs compared to DM and CG at both frequencies and locations. Skin was harder in DPN compared to CG (heel). No differences were observed in skin thickness. VPTs at 30 and 200 Hz correlated negatively with skin hardness for DPN and with skin thickness for DM, respectively. This means, the harder or thicker the skin, the better the perception of 30 or 200 Hz vibrations. Changes in MSP may compensate the loss of sensitivity up to a certain progression of the disease. However, the influence seems rather small when considering other parameters, such as age.

2020 ◽  
Vol 9 (3) ◽  
pp. 794
Author(s):  
Raúl Juan Molines-Barroso ◽  
Yolanda García-Álvarez ◽  
José Luis García-Klepzig ◽  
Esther García-Morales ◽  
Francisco Javier Álvaro-Afonso ◽  
...  

We aimed to evaluate the differences in the sub-metatarsal skin and fat pad atrophy between patients at a high risk of ulceration with and without previous metatarsal head resection. A cross-sectional study was performed in a diabetic foot unit involving 19 participants with a history of metatarsal head resection (experimental group) and 19 (control group) without a history of metatarsal head resection but with an ulcer in other locations in the metatarsal head. No participants had active ulcerations at study inclusion. Sub-metatarsal skin thickness and fat pad thickness in the first and second metatarsals were evaluated by an ultrasound transducer. The experimental group showed sub-metatarsal fat pad atrophy (3.74 ± 1.18 mm and 2.52 ± 1.04 mm for first and second metatarsal, respectively) compared with the control group (5.44 ± 1.12 mm and 4.73 ± 1.59 mm) (p < 0.001, confidence interval: (CI): 0.943–2.457 and p < 0.001, CI: 1.143–3.270 for first and second metatarsal, respectively); however, sub-metatarsal skin thickness was not different between groups (experimental 2.47 ± 0.47 mm vs. control 2.80 ± 0.58 mm (p = 0.063, CI: −0.019–0.672) and 2.24 ± 0.60 mm vs. 2.62 ± 0.50 mm (p = 0.066, CI: −0.027–0.786) for first and second metatarsal, respectively). Patients with previous metatarsal head resection showed sub-metatarsal fat pad atrophy, which could be associated with the risk of reulceration in the metatarsal head.


2021 ◽  
Vol 10 (14) ◽  
pp. 3073
Author(s):  
Tina J. Drechsel ◽  
Renan L. Monteiro ◽  
Claudio Zippenfennig ◽  
Jane S. S. P. Ferreira ◽  
Thomas L. Milani ◽  
...  

Recent studies demonstrate neuropathic changes with respect to vibration sensitivity for different measurement frequencies. This study investigates the relationship between vibration perception thresholds (VPTs) at low and high frequencies at two plantar locations and diabetic peripheral neuropathy (DPN) severity in diabetes mellitus (DM) subjects with DPN. We examine differences of VPTs between participants with DM, with DPN, as well as healthy controls. The influence of anthropometric, demographic parameters, and DM duration on VPTs is studied. Thirty-three healthy control group subjects (CG: 56.3 ± 9.9 years) and 33 with DM are studied. DM participants are subdivided into DM group (DM without DPN, n = 20, 53.3 ± 15.1 years), and DPN group (DM with DPN, n = 13, 61.0 ± 14.5 years). VPTs are measured at the first metatarsal head (MTH1) and heel (30 Hz, 200 Hz), using a customized vibration exciter. Spearman and Pearson correlations are used to identify relationships between VPTs and clinical parameters. ANOVAs are calculated to compare VPTs among groups. Significant correlations are observed between DPN severity (by fuzzy scores) and VPTs at both locations and frequencies (MTH1_30 Hz vs. fuzzy: r = 0.68, p = 0.011; Heel_30 Hz vs. fuzzy: r = 0.66, p = 0.014; MTH1_200 Hz vs. fuzzy: r = 0.73, p = 0.005; Heel_200 Hz vs. fuzzy: r = 0.60, p = 0.032). VPTs in CG and DM groups are significantly smaller than the DPN group, showing higher contrasts for the 30 Hz compared to the 200 Hz measurement. The correlations between fuzzy scores and VPTs confirm the relevance of using low and high frequencies to assess a comprehensive foot sensitivity status in people with DM.


2020 ◽  
Author(s):  
Caiying Feng ◽  
Jie You ◽  
Guixia Chen ◽  
Hongli Su ◽  
Li Zhang ◽  
...  

Abstract Background Previous studies have discovered that zinc-α2-glycoprotein is related to insulin resistance and lipid metabolism. The aim of the study is to explore the change of serum zinc-α2-glycoprotein(ZAG) and its related factors in gestational diabetes mellitus(GDM). Methods Eighty newly diagnosed GDM patients were enrolled in study group, and 80 normal pregnant women were selected as control group. The differences of baseline data between the two groups were compared, and the change of serum ZAG level and its relationship with related indexes was analyzed. Results Compared to control group, the level of serum ZAG in the study group decreased [(43.94 ± 14.51)mg/L vs. (62.57 ± 19.05)mg/L, P < 0.001]. Pearson correlation (or Spearman correlation) analysis showed that serum ZAG level was negatively correlated with FPG, FINS, HOMA-IR and TG (P < 0.05) and positively correlated with HDL(P < 0.05). Multiple linear regression showed that HDL, FINS, HOMA-IR were independent factors of serum ZAG(P < 0.001). Conclusion The level of serum ZAG in patients with gestational diabetes mellitus decreased, and HDL, FINS and HOMA-IR are the influencing factors in study group. Trial registration: The study registered in the Chinese Clinical Trial Registry(Chi CTR2000028811).


2018 ◽  
Vol 7 (1) ◽  
pp. 361-373
Author(s):  
Elias Ferreira Porto ◽  
Claudia Kumpel ◽  
Anselmo Cordeiro de Souza ◽  
Izabel Maria de Oliveira ◽  
Karoline Mayara de Aquiles Bernardo ◽  
...  

Avaliar o estilo de vida e percepção do estado geral de saúde em pacientes com Diabetes Mellitus tipo 2 - DM, Hipertensão Arterial Sistêmica - HAS e indivíduos saudáveis. Métodos: Estudo transversal, com grupo controle. Avaliado estilo de vida com Questionário Fantástico, e percepção geral de saúde via uma pergunta âncora de diabéticos do tipo 2 (n = 37), hipertensos (n = 60), e indivíduos saudáveis (n = 43). Análise estatística descritiva, analise de variância, e razão de chance (Odds Rattio – OR). Resultados: Verificou-se diferença significante (p0,0001) na pontuação do Questionário Fantástico entre os indivíduos saudáveis em relação DM e HAS. O pior desempenho no estilo de vida para os três grupos foi nos domínios de atividade física e alimentação. O risco do indivíduo com HAS afirmar que sua saúde é pior do que indivíduos da mesma faixa etária foi OR 1.8 (1.415 a 2.419) e para os indivíduos diabéticos OR de 2.8 (1.776 a 4.579) em relação a indivíduos saudáveis. Conclusão: Diabéticos e hipertensos têm um pior estilo de vida e percepção geral de saúde do que indivíduos saudáveis. Assim o estilo de vida saudável pode reduzir a prevalência e auxiliar no controle de doenças já estabelecidas.Palavras-chave: Estilo de vida. Hipertensão Arterial. Diabetes Mellitus. ABSTRACT: To evaluate the lifestyle and perception of general health status in patients with type 2 diabetes mellitus - DM, systemic arterial hypertension - SAH and healthy individuals. Methods: Cross-sectional study with control group. (N = 37), hypertensive (n = 60), and healthy subjects (n = 43) were assessed using a Fantastic Questionnaire, and general health perception via an anchor question. Descriptive statistical analysis, analysis of variance, and odds ratio (Odds Rattio - OR). Results: There was a significant difference (p 0.0001) in the score of the Fantastic Questionnaire among healthy individuals in relation to DM and SAH. The worst lifestyle performance for the three groups was in the physical activity and feeding domains. The risk of the individual with SAH to state that their health is worse than individuals of the same age group was OR 1.8 (1.415 to 2.419) and for the diabetic individuals OR of 2.8 (1.776 to 4.579) in relation to healthy individuals. Conclusion: Diabetics and hypertensives have a worse lifestyle and overall health perception than healthy individuals. Thus the healthy lifestyle can reduce the prevalence and help in the control of already established diseases.Keywords: Lifestyle. Hypertension. Diabetes Mellitus.


2021 ◽  
Vol 7 (1) ◽  
pp. 10-16
Author(s):  
Vahid Shaygannejad ◽  
◽  
Mahdi Barzegar ◽  
Navid Manouchehri ◽  
Nafiseh Esmaeil ◽  
...  

Background: The absence of Aquaporin-4 Antibody (AQP4-Ab) in a fraction of the Neuromyelitis Optica Spectrum Disorder (NMOSD) patients has led to a search for other serologic markers. Myelin Oligodendrocyte Glycoprotein (MOG) is a protein component of the myelin sheets encapsulating the neural fibers. Objectives: We aimed to compare the presence and levels of anti-MOG (Ig-G) in a group of seronegative NMOSD patients with a healthy control group. Materials & Methods: In this cross-sectional study, 30 NMOSD patients with negative AQP-Ab status, who were referred to the Neurology Clinic of Kashani University Hospital in Isfahan City, Iran, from March 2015 to March 2016, and 26 healthy controls were consecutively recruited. Their baseline demographic and clinical data were recorded. Serum anti-MOG levels were measured in both groups. The obtained data were analyzed using the Student t-test, Mann-Whitney U, and Chisquare test in SPSS V. 18. Results: The anti-MOG test results were statistically higher in patients (n=12, 37.5%) compared to controls (n=0, 0%) (P<0.0001). The level of anti-MOG in Healthy Control (HC) was higher compared to patients with negative anti-MOG (P<0.0001) and was lower than patients with positive anti-MOG (P<0.0001). Conclusion: Our study showed that nearly one-third of seronegative NMOSD patients were positive for MOG-Ab. Further studies are needed to assess the characteristics and outcome of these patients.


2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Parisa Behzadi ◽  
Firouzeh Torabi ◽  
Massoud Amini ◽  
Ashraf Aminorroaya

Oxidized low density lipoprotein (ox-LDL) is a product of oxidative stress. In this cross-sectional study, we compared the ox-LDL concentrations in diabetic patients with normoalbuminuria (n=28), microalbuminuria (n=28), and macroalbuminuria (n=28) with their first degree relatives (n=28) and healthy control people (n=31). They were selected by consecutive patient selection method. The ox-LDL level was assayed using ELISA. We measured blood pressure, lipid profile, fasting plasma glucose (FPG), and HbA1c in all groups. There was no significant difference in ox-LDL concentrations among normoalbuminuric, microalbuminuric, and macroalbuminuric diabetic groups. In diabetic patients with micro- and macroalbuminuria, ox-LDL concentration was higher than their first degree relatives (P=0.04andP=0.03) and control group (P=0.001andP=0.03, resp.). In normoalbuminuric diabetic persons, ox-LDL concentration was just higher than that of healthy people (P=0.02). There was no statistically significant difference in ox-LDL levels between normoalbuminuric diabetic patients and their first degree relatives. In conclusion, the presence and progression of albuminuria in diabetic patients are not related to ox-LDL concentration and genetic predisposition influences the plasma OX-LDL level. Larger sample size is needed to confirm this conclusion in future studies.


Author(s):  
Mariam A. Atiia ◽  
Yasser M. Hafez ◽  
Maaly M. Mabrouk ◽  
Medhat A. Ghazy

Background: Interleukin-19 (IL-19) is a newly discovered cytokine belonging to the Interleukin-10 (IL-10) family. IL-19 has indispensable functions in many inflammatory processes and also can induce the angiogenic potential of endothelial cells. The purpose of present study was to assess the level of serum interleukin-19 (IL-19) in patients with diabetic nephropathy (DN). Our Study Aimed to assess the level of serum IL-19 in patients with diabetic nephropathy. Methods: In this cross-sectional study, we tested 90 subjects; 30 healthy control and 60 diabetic nephropathy patients recruited from outpatient clinics and wards of Internal Medicine department, Tanta university hospitals, Egypt. Patients were subdivided into 3subgroup according to the urinary albumin creatinine ratio (ACR). Results: The serum IL-19 levels in DN patients were significantly higher than the control group. The mean serum IL-19 level was 15.45±4.34 Pg/ml, 32.66±8.05 Pg/ml, 56.03±7.89 Pg/ml and 71.41±12.37 Pg/ml dL for control, normoalbuminuria group, microalbuminuria group and macroalbuminuria group respectively. Conclusions: Serum IL-19 level was significantly elevated in patients with diabetic nephropathy and was associated with the marker of inflammation CRP (C -reactive protein). So


2019 ◽  
Vol 47 (9) ◽  
pp. 941-946 ◽  
Author(s):  
Tim Hetkamp ◽  
Kerstin Hammer ◽  
Mareike Möllers ◽  
Helen A. Köster ◽  
Maria K. Falkenberg ◽  
...  

Abstract Background The aim of this study was to compare the adrenal gland size of fetuses of women with gestational diabetes mellitus (GDM) with that of healthy control fetuses. Methods This prospective cross-sectional study included measurements of the adrenal gland size of 62 GDM fetuses (GDM group) and 370 normal controls (control group) between the 19th and 41st week of gestation. A standardized transversal plane was used to measure the total width and the medulla width. The cortex width and an adrenal gland ratio (total width/medulla width) were calculated from these data. Adrenal gland size measurements were adjusted to the week of gestation and compared between the two groups in a multivariable linear regression analysis. A variance decomposition metric was used to compare the relative importance of predictors of the different adrenal gland size measurements. Results For all the investigated parameters of the adrenal gland size, increased values were found in the case of GDM (P < 0.05), while adjusting for the week of gestation. GDM seems to have a greater impact on the size of the cortex than on the size of the medulla. Conclusion The fetal adrenal gland is enlarged in pregnancy complicated by GDM. The width of the cortex seems to be particularly affected.


Author(s):  
Fatma S. Shehata ◽  
Yasser M. Abd Elraouf ◽  
Hisham A. El Serogy ◽  
Wael F. Mohamed

Aims: To evaluate the effect of subclinical and overt hypothyroidism on mean platelet volume (MPV) and platelet distribution width (PDW). Study Design: Cross sectional study. Place and Duration of Study: Outpatient Clinic of Diabetes, Metabolism and Endocrinology Unit in internal medicine department and clinical pathology, Tanta University, Egypt in a period between June 2018 to June 2019. Methodology: We tested 250 subjects; 50 healthy control and 200 hypothyroid patients (all were female; age ≥18 years old age) without any medical history, then patients were subdivided into newly diagnosed group and another group on l-thyroxin treatment. Platelet parameters (MPV, PDW) were assessed in all of them. Results: MPV & PDW is increasing in hypothyroid patients than control group (8.93 ± 0.62), more in overt group (10.88 ± 0.57) than subclinical group (10.02 ± 0.55). No significant reduction in MPV and PDW in patients on l-thyroxin treatment which suggest that l-thyroxin treatment couldn’t produce difference till patients reaching their target level being euthyroid. Conclusion: We recommend the usefulness of MPV and PDW as inexpensive markers of platelet activation in diagnostic work-up of athero-thrombotic complications risk in patients with subclinical and overt hypothyroidism.


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