Plantar Tissue Characteristics in People With Diabetes With and Without Peripheral Neuropathy: A Novel Explanatory Model for DPN Risk Assessment

ABSTRACT Objectives Diabetic peripheral neuropathy (DPN) may affect the biomechanical properties and morphology of the plantar tissue. This study aimed to compare plantar stiffness and thickness in individuals with diabetes with and without DPN and develop a novel explanatory model for DPN risk asse...

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Main Authors: Yiming Li, Wei Wu, Liyun Xue, Tianyu Zhao, Yucheng Lu, Xiaohui Qiao, Hong Ding
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:Journal of Diabetes
Subjects:
Online Access:https://doi.org/10.1111/1753-0407.70094
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author Yiming Li
Wei Wu
Liyun Xue
Tianyu Zhao
Yucheng Lu
Xiaohui Qiao
Hong Ding
author_facet Yiming Li
Wei Wu
Liyun Xue
Tianyu Zhao
Yucheng Lu
Xiaohui Qiao
Hong Ding
author_sort Yiming Li
collection DOAJ
description ABSTRACT Objectives Diabetic peripheral neuropathy (DPN) may affect the biomechanical properties and morphology of the plantar tissue. This study aimed to compare plantar stiffness and thickness in individuals with diabetes with and without DPN and develop a novel explanatory model for DPN risk assessment by integrating these measures with clinical parameters. Materials & Methods Thirty‐two healthy controls and 84 people with diabetes (41 with DPN and 43 without DPN) were included. Shear wave elastography evaluated plantar thickness and stiffness at the heel, hallux, and first and fifth metatarsal heads (1st MTH, 5th MTH). An integrated thickness or stiffness index was generated at multiple locations by principal component analysis (PCA). Results People with DPN showed a significant increase in plantar thickness (heel, 1st MTH) (p < 0.001) and stiffness (all tested locations) compared to healthy controls (p < 0.05). Moreover, plantar thickness at 1st MTH, plantar stiffness at 5th MTH, and integrated stiffness index generated by PCA were significantly higher in DPN than in the non‐DPN group (p < 0.05). A DPN explanatory model was developed using multivariate logistic regression, incorporating the integrated plantar stiffness index, diabetes duration, and gender. The model showed high discriminative ability (AUROC: 97.7%), with an optimal cutoff of 0.56 yielding 92.7% sensitivity and 95.3% specificity. Conclusion The integrated plantar stiffness index, combined with gender and diabetes duration, offers a novel approach for DPN, providing a noninvasive tool for DPN risk assessment.
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spelling doaj-art-b2b3b3d28eab4523bf7722acb04f427c2025-08-20T02:17:00ZengWileyJournal of Diabetes1753-03931753-04072025-05-01175n/an/a10.1111/1753-0407.70094Plantar Tissue Characteristics in People With Diabetes With and Without Peripheral Neuropathy: A Novel Explanatory Model for DPN Risk AssessmentYiming Li0Wei Wu1Liyun Xue2Tianyu Zhao3Yucheng Lu4Xiaohui Qiao5Hong Ding6Department of Ultrasound Huashan Hospital, Fudan University Shanghai ChinaDepartment of Endocrine Huashan Hospital, Fudan University Shanghai ChinaDepartment of Ultrasound Huashan Hospital, Fudan University Shanghai ChinaDepartment of Ultrasound Huashan Hospital, Fudan University Shanghai ChinaDepartment of Radiology Huashan Hospital, Fudan University Shanghai ChinaDepartment of Ultrasound Huashan Hospital, Fudan University Shanghai ChinaDepartment of Ultrasound Huashan Hospital, Fudan University Shanghai ChinaABSTRACT Objectives Diabetic peripheral neuropathy (DPN) may affect the biomechanical properties and morphology of the plantar tissue. This study aimed to compare plantar stiffness and thickness in individuals with diabetes with and without DPN and develop a novel explanatory model for DPN risk assessment by integrating these measures with clinical parameters. Materials & Methods Thirty‐two healthy controls and 84 people with diabetes (41 with DPN and 43 without DPN) were included. Shear wave elastography evaluated plantar thickness and stiffness at the heel, hallux, and first and fifth metatarsal heads (1st MTH, 5th MTH). An integrated thickness or stiffness index was generated at multiple locations by principal component analysis (PCA). Results People with DPN showed a significant increase in plantar thickness (heel, 1st MTH) (p < 0.001) and stiffness (all tested locations) compared to healthy controls (p < 0.05). Moreover, plantar thickness at 1st MTH, plantar stiffness at 5th MTH, and integrated stiffness index generated by PCA were significantly higher in DPN than in the non‐DPN group (p < 0.05). A DPN explanatory model was developed using multivariate logistic regression, incorporating the integrated plantar stiffness index, diabetes duration, and gender. The model showed high discriminative ability (AUROC: 97.7%), with an optimal cutoff of 0.56 yielding 92.7% sensitivity and 95.3% specificity. Conclusion The integrated plantar stiffness index, combined with gender and diabetes duration, offers a novel approach for DPN, providing a noninvasive tool for DPN risk assessment.https://doi.org/10.1111/1753-0407.70094diabetic peripheral neuropathyplantarsonoelastographystiffnessthickness
spellingShingle Yiming Li
Wei Wu
Liyun Xue
Tianyu Zhao
Yucheng Lu
Xiaohui Qiao
Hong Ding
Plantar Tissue Characteristics in People With Diabetes With and Without Peripheral Neuropathy: A Novel Explanatory Model for DPN Risk Assessment
Journal of Diabetes
diabetic peripheral neuropathy
plantar
sonoelastography
stiffness
thickness
title Plantar Tissue Characteristics in People With Diabetes With and Without Peripheral Neuropathy: A Novel Explanatory Model for DPN Risk Assessment
title_full Plantar Tissue Characteristics in People With Diabetes With and Without Peripheral Neuropathy: A Novel Explanatory Model for DPN Risk Assessment
title_fullStr Plantar Tissue Characteristics in People With Diabetes With and Without Peripheral Neuropathy: A Novel Explanatory Model for DPN Risk Assessment
title_full_unstemmed Plantar Tissue Characteristics in People With Diabetes With and Without Peripheral Neuropathy: A Novel Explanatory Model for DPN Risk Assessment
title_short Plantar Tissue Characteristics in People With Diabetes With and Without Peripheral Neuropathy: A Novel Explanatory Model for DPN Risk Assessment
title_sort plantar tissue characteristics in people with diabetes with and without peripheral neuropathy a novel explanatory model for dpn risk assessment
topic diabetic peripheral neuropathy
plantar
sonoelastography
stiffness
thickness
url https://doi.org/10.1111/1753-0407.70094
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