Ultrasound exploration of muscle characteristic changes and diabetic peripheral neuropathy in diabetic patients

Purpose Using brightness mode ultrasound combined with shear wave elastography, this study aims to detect structural and functional changes of the medial head of gastrocnemius (MG) in type 2 diabetes mellitus (T2DM) patients with or without diabetic peripheral neuropathy (DPN). Methods 149 T2DM patients (DPN group and non-DPN group) and 60 healthy volunteers (control group) were enrolled. We measured the absolute difference of fascicle length (FL), pennation angle (PA), and shear wave velocity (SWV) of both MG in neutral position and maximal ankle joint's plantar flexion and calculated Delta FL, Delta PA, and Delta SWV. These three parameters, along with muscle thickness (MT), were compared among the three groups. Results In the DPN group, the MG's MT, Delta PA, and Delta SWV were significantly lower than in the non-DPN group (p < 0.01); these parameters achieved the highest scores in the control group (p < 0.01). The area under the receiver operating characteristic curve of the combination of Delta SWV and Delta FL was the largest for predicting inpatients with or without DPN. Conclusions Decreased muscle mass (MT) and muscle contractibility (Delta FL and Delta SWV) were detected in patients with T2DM, with or without DPN. Delta SWV and Delta FL of the MG showed high-diagnostic accuracy for DPN warning signs.