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Assessment of Microcirculation in the Type 2 Diabetic and Impaired Glucose Tolerance Feet of Elderly Men by CEUS
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy ( IF 3.3 ) Pub Date : 2021-08-11 , DOI: 10.2147/dmso.s314727 Xiaoyu Li 1 , Lin Wu 2 , Zhifang Yang 1 , Yunyun Hu 1 , Chun Zhou 1 , Ri Ji 1
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy ( IF 3.3 ) Pub Date : 2021-08-11 , DOI: 10.2147/dmso.s314727 Xiaoyu Li 1 , Lin Wu 2 , Zhifang Yang 1 , Yunyun Hu 1 , Chun Zhou 1 , Ri Ji 1
Affiliation
Objective: To evaluate the foot microcirculation in type 2 diabetes mellitus (T2DM) and impaired glucose tolerance patients (IGT) with contrast-enhanced ultrasound (CEUS).
Methods: The study included 37 patients with T2DM but without diabetic foot (DM group), 15 patients with impaired glucose tolerance (IGT group) and 10 elderly males with normal fasting blood glucose (FBS) and negative glucose tolerance tests (control group). Color Doppler flow imaging (CDFI) and CEUS were performed on the right foot great toes for detecting the blood perfusion performance. CEUS images were recorded and parameters of CDFI and flow time-intensity curves (TICs) were analyzed by the Student’s t-test.
Results: There was no significant difference in CDFI parameters pulse index and peak systolic blood flow velocity (PSV) among the three groups (P > 0.05). Compared with control group, CEUS images of IGT and DM groups showed lower microvascular density and were pale. Peak intensity (PI) and area under time-intensity curve (AUC) in control, IGT and DM groups were decreased gradually (PI 46.36± 10.96 vs 35.26± 11.65 vs 28.15± 7.94, P = 0.001, AUC 5.12± 1.02 vs 3.25± 1.60 vs 2.81± 1.20, P = 0.001). The arrival times (AT) and time to peak (TTP) tended to be increased with the extension of DM course, but the difference was not statistically significant (AT, P = 0.260, TTP, P = 0.481).
Conclusion: CEUS, as a noninvasive and valuable technique, could detect the alterations in foot microcirculation of DM and IGT patients.
Keywords: type 2 diabetes mellitus, impaired glucose tolerance, contrast-enhanced ultrasound, microcirculation
中文翻译：
CEUS对老年男性2型糖尿病和葡萄糖耐量受损足部微循环的评估
目的：利用超声造影（CEUS）评估2型糖尿病（T2DM）和糖耐量受损患者（IGT）的足部微循环。
方法：本研究纳入37例无糖尿病足的T2DM患者（DM组）、15例糖耐量异常患者（IGT组）和10例空腹血糖（FBS）正常且糖耐量试验阴性的老年男性（对照组）。对右脚大脚趾进行彩色多普勒血流成像 (CDFI) 和 CEUS 以检测血液灌注性能。记录 CEUS 图像并通过学生t检验分析 CDFI 和流动时间强度曲线 (TIC) 的参数。
结果：三组间CDFI参数脉搏指数和收缩期峰值血流速度（PSV）差异无统计学意义（P>0.05）。与对照组相比，IGT和DM组的CEUS图像显示微血管密度较低，颜色苍白。对照组、IGT和DM组的峰值强度（PI）和时间强度曲线下面积（AUC）逐渐降低（PI 46.36±10.96 vs 35.26±11.65 vs 28.15±7.94，P = 0.001，AUC 5.12±1.02 vs 3.25± 1.60 与 2.81± 1.20，P = 0.001）。到达时间（AT）和达峰时间（TTP）随DM航程的延长而增加，但差异无统计学意义（AT，P=0.260，TTP，P=0.481）。
结论： CEUS作为一种无创且有价值的技术，可以检测DM和IGT患者足部微循环的改变。
【关键词】： 2型糖尿病 糖耐量异常 超声造影 微循环
更新日期：2021-08-10
Methods: The study included 37 patients with T2DM but without diabetic foot (DM group), 15 patients with impaired glucose tolerance (IGT group) and 10 elderly males with normal fasting blood glucose (FBS) and negative glucose tolerance tests (control group). Color Doppler flow imaging (CDFI) and CEUS were performed on the right foot great toes for detecting the blood perfusion performance. CEUS images were recorded and parameters of CDFI and flow time-intensity curves (TICs) were analyzed by the Student’s t-test.
Results: There was no significant difference in CDFI parameters pulse index and peak systolic blood flow velocity (PSV) among the three groups (P > 0.05). Compared with control group, CEUS images of IGT and DM groups showed lower microvascular density and were pale. Peak intensity (PI) and area under time-intensity curve (AUC) in control, IGT and DM groups were decreased gradually (PI 46.36± 10.96 vs 35.26± 11.65 vs 28.15± 7.94, P = 0.001, AUC 5.12± 1.02 vs 3.25± 1.60 vs 2.81± 1.20, P = 0.001). The arrival times (AT) and time to peak (TTP) tended to be increased with the extension of DM course, but the difference was not statistically significant (AT, P = 0.260, TTP, P = 0.481).
Conclusion: CEUS, as a noninvasive and valuable technique, could detect the alterations in foot microcirculation of DM and IGT patients.
Keywords: type 2 diabetes mellitus, impaired glucose tolerance, contrast-enhanced ultrasound, microcirculation
中文翻译：
CEUS对老年男性2型糖尿病和葡萄糖耐量受损足部微循环的评估
目的：利用超声造影（CEUS）评估2型糖尿病（T2DM）和糖耐量受损患者（IGT）的足部微循环。
方法：本研究纳入37例无糖尿病足的T2DM患者（DM组）、15例糖耐量异常患者（IGT组）和10例空腹血糖（FBS）正常且糖耐量试验阴性的老年男性（对照组）。对右脚大脚趾进行彩色多普勒血流成像 (CDFI) 和 CEUS 以检测血液灌注性能。记录 CEUS 图像并通过学生t检验分析 CDFI 和流动时间强度曲线 (TIC) 的参数。
结果：三组间CDFI参数脉搏指数和收缩期峰值血流速度（PSV）差异无统计学意义（P>0.05）。与对照组相比，IGT和DM组的CEUS图像显示微血管密度较低，颜色苍白。对照组、IGT和DM组的峰值强度（PI）和时间强度曲线下面积（AUC）逐渐降低（PI 46.36±10.96 vs 35.26±11.65 vs 28.15±7.94，P = 0.001，AUC 5.12±1.02 vs 3.25± 1.60 与 2.81± 1.20，P = 0.001）。到达时间（AT）和达峰时间（TTP）随DM航程的延长而增加，但差异无统计学意义（AT，P=0.260，TTP，P=0.481）。
结论： CEUS作为一种无创且有价值的技术，可以检测DM和IGT患者足部微循环的改变。
【关键词】： 2型糖尿病 糖耐量异常 超声造影 微循环
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