PLoS ONE (Jan 2017)

Plantar fascia enthesopathy is highly prevalent in diabetic patients without peripheral neuropathy and correlates with retinopathy and impaired kidney function.

  • Francesco Ursini,
  • Franco Arturi,
  • Kassandra Nicolosi,
  • Antonio Ammendolia,
  • Salvatore D'Angelo,
  • Emilio Russo,
  • Saverio Naty,
  • Caterina Bruno,
  • Giovambattista De Sarro,
  • Ignazio Olivieri,
  • Rosa Daniela Grembiale

DOI
https://doi.org/10.1371/journal.pone.0174529
Journal volume & issue
Vol. 12, no. 3
p. e0174529

Abstract

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BACKGROUND:Aim of this study was to evaluate the prevalence of plantar fascia (PF) enthesopathy in Type 2 diabetes mellitus (T2DM) patients without distal peripheral neuropathy (DPN). METHODS:We recruited 50 T2DM patients without DPN and 50 healthy controls. DPN was excluded using the Michigan Neuropathy Screening Instrument (MNSI). All patients underwent a bilateral sonographicevaluation of the enthesealportion of the PF. RESULTS:PF thickness was significantly higher in T2DM patients (p<0.0001). T2DM patients presented a higher prevalence of entheseal thickening (p = 0.002), enthesophyte (p = 0.02) and cortical irregularity (p = 0.02). The overall sum of abnormalities was higher in T2DM patients (p<0.0001), as was the percentage of bilateral involvement (p = 0.005). In a logistic regression analysis, retinopathy predicted entheseal thickening (OR 3.5, p = 0.05) and enthesophytes (OR 5.13, p = 0.001); reduced eGFR predicted enthesophytes (OR 2.93, p = 0.04); body mass index (BMI) predicted cortical irregularity (OR 0.87, p = 0.05); mean glucose predicted enthesophyte (OR 1.01, p = 0.03); LDL cholesterol predicted cortical irregularity (OR 0.98, p = 0.02). CONCLUSIONS:Our data suggest that T2DM is associated with PF enthesopathyindependently of DPN.