Ultrasound and Clinical Alterations in the Foot of Children with Obesity and Diabetes
Background. Alterations in plantar soft tissues are often reported in adults with diabetes, whereas data on children are conflicting. Also, the extent of foot damage caused by excess body fat in children has not been fully characterized yet. This study aimed to address the relationship between body...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-08-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/13/17/2781 |
| _version_ | 1797582670340816896 |
|---|---|
| author | Martina Pappalardo Laura Gori Emioli Randazzo Riccardo Morganti Michelangelo Scaglione Margherita Valiani Alessandra Beni Maria Di Cicco Diego G. Peroni Ferdinando Franzoni Pasquale Comberiati |
| author_facet | Martina Pappalardo Laura Gori Emioli Randazzo Riccardo Morganti Michelangelo Scaglione Margherita Valiani Alessandra Beni Maria Di Cicco Diego G. Peroni Ferdinando Franzoni Pasquale Comberiati |
| author_sort | Martina Pappalardo |
| collection | DOAJ |
| description | Background. Alterations in plantar soft tissues are often reported in adults with diabetes, whereas data on children are conflicting. Also, the extent of foot damage caused by excess body fat in children has not been fully characterized yet. This study aimed to address the relationship between body mass and structural changes of the foot in children and adolescents with and without diabetes. Methods. In a case-control study, 43 participants (age 13 ± 2.6 years) were recruited, 29 (67%) with type 1 diabetes (T1D) and 14 (33%) controls. Anthropometric parameters [body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR)], foot posture index-6 (FPI-6) for static foot posture, and navicular drop test (NDT) for medial longitudinal arch height (MLA) were measured in all participants. The thickness of the midfoot plantar fascia (MPF) and medial midfoot fat pad (MMFP) were quantified using ultrasound. Results. No differences in clinical and ultrasonographical parameters were observed between the study groups. MMFP thickness was correlated with MPF thickness (<i>p</i> = 0.027). MMFP and MPF thicknesses were positively associated with BMI (<i>p</i> < 0.001 and <i>p</i> = 0.013, respectively), WC (<i>p</i> < 0.001 and <i>p</i> = 0.013), and WHtR (<i>p</i> < 0.001 and <i>p</i> = 0.026). The NDT measured on the right and left foot correlated with WHtR (<i>p</i> = 0.038 and <i>p</i> = 0.009, respectively), but not with WC and BMI. Conclusions. Children with T1D show structural alterations of plantar soft tissues which seem related to body mass increase rather than diabetes pathology. Ultrasound is a valuable tool to assess early structural changes of the foot in young people with an elevated BMI. |
| first_indexed | 2024-03-10T23:25:47Z |
| format | Article |
| id | doaj.art-7a2f4448d43f425fb78be9a11a29cbef |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T23:25:47Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-7a2f4448d43f425fb78be9a11a29cbef2023-11-19T07:59:29ZengMDPI AGDiagnostics2075-44182023-08-011317278110.3390/diagnostics13172781Ultrasound and Clinical Alterations in the Foot of Children with Obesity and DiabetesMartina Pappalardo0Laura Gori1Emioli Randazzo2Riccardo Morganti3Michelangelo Scaglione4Margherita Valiani5Alessandra Beni6Maria Di Cicco7Diego G. Peroni8Ferdinando Franzoni9Pasquale Comberiati10Azienda Ospedaliero Universitaria Pisana, UO Pediatria Universitaria, 56126 Pisa, ItalyAzienda Ospedaliero Universitaria Pisana, UO Pediatria Universitaria, 56126 Pisa, ItalyAzienda Ospedaliero Universitaria Pisana, UO Pediatria Universitaria, 56126 Pisa, ItalySection of Statistics, University Hospital of Pisa, 56126 Pisa, ItalyFirst Orthopedic and Traumatologic Clinic, University of Pisa, 56126 Pisa, ItalyAzienda Ospedaliero Universitaria Pisana, UO Pediatria Universitaria, 56126 Pisa, ItalyAzienda Ospedaliero Universitaria Pisana, UO Pediatria Universitaria, 56126 Pisa, ItalyAzienda Ospedaliero Universitaria Pisana, UO Pediatria Universitaria, 56126 Pisa, ItalyAzienda Ospedaliero Universitaria Pisana, UO Pediatria Universitaria, 56126 Pisa, ItalyDepartment of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyAzienda Ospedaliero Universitaria Pisana, UO Pediatria Universitaria, 56126 Pisa, ItalyBackground. Alterations in plantar soft tissues are often reported in adults with diabetes, whereas data on children are conflicting. Also, the extent of foot damage caused by excess body fat in children has not been fully characterized yet. This study aimed to address the relationship between body mass and structural changes of the foot in children and adolescents with and without diabetes. Methods. In a case-control study, 43 participants (age 13 ± 2.6 years) were recruited, 29 (67%) with type 1 diabetes (T1D) and 14 (33%) controls. Anthropometric parameters [body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR)], foot posture index-6 (FPI-6) for static foot posture, and navicular drop test (NDT) for medial longitudinal arch height (MLA) were measured in all participants. The thickness of the midfoot plantar fascia (MPF) and medial midfoot fat pad (MMFP) were quantified using ultrasound. Results. No differences in clinical and ultrasonographical parameters were observed between the study groups. MMFP thickness was correlated with MPF thickness (<i>p</i> = 0.027). MMFP and MPF thicknesses were positively associated with BMI (<i>p</i> < 0.001 and <i>p</i> = 0.013, respectively), WC (<i>p</i> < 0.001 and <i>p</i> = 0.013), and WHtR (<i>p</i> < 0.001 and <i>p</i> = 0.026). The NDT measured on the right and left foot correlated with WHtR (<i>p</i> = 0.038 and <i>p</i> = 0.009, respectively), but not with WC and BMI. Conclusions. Children with T1D show structural alterations of plantar soft tissues which seem related to body mass increase rather than diabetes pathology. Ultrasound is a valuable tool to assess early structural changes of the foot in young people with an elevated BMI.https://www.mdpi.com/2075-4418/13/17/2781anthropometrybody massdiabetesfootobesityplantar fascia |
| spellingShingle | Martina Pappalardo Laura Gori Emioli Randazzo Riccardo Morganti Michelangelo Scaglione Margherita Valiani Alessandra Beni Maria Di Cicco Diego G. Peroni Ferdinando Franzoni Pasquale Comberiati Ultrasound and Clinical Alterations in the Foot of Children with Obesity and Diabetes Diagnostics anthropometry body mass diabetes foot obesity plantar fascia |
| title | Ultrasound and Clinical Alterations in the Foot of Children with Obesity and Diabetes |
| title_full | Ultrasound and Clinical Alterations in the Foot of Children with Obesity and Diabetes |
| title_fullStr | Ultrasound and Clinical Alterations in the Foot of Children with Obesity and Diabetes |
| title_full_unstemmed | Ultrasound and Clinical Alterations in the Foot of Children with Obesity and Diabetes |
| title_short | Ultrasound and Clinical Alterations in the Foot of Children with Obesity and Diabetes |
| title_sort | ultrasound and clinical alterations in the foot of children with obesity and diabetes |
| topic | anthropometry body mass diabetes foot obesity plantar fascia |
| url | https://www.mdpi.com/2075-4418/13/17/2781 |
| work_keys_str_mv | AT martinapappalardo ultrasoundandclinicalalterationsinthefootofchildrenwithobesityanddiabetes AT lauragori ultrasoundandclinicalalterationsinthefootofchildrenwithobesityanddiabetes AT emiolirandazzo ultrasoundandclinicalalterationsinthefootofchildrenwithobesityanddiabetes AT riccardomorganti ultrasoundandclinicalalterationsinthefootofchildrenwithobesityanddiabetes AT michelangeloscaglione ultrasoundandclinicalalterationsinthefootofchildrenwithobesityanddiabetes AT margheritavaliani ultrasoundandclinicalalterationsinthefootofchildrenwithobesityanddiabetes AT alessandrabeni ultrasoundandclinicalalterationsinthefootofchildrenwithobesityanddiabetes AT mariadicicco ultrasoundandclinicalalterationsinthefootofchildrenwithobesityanddiabetes AT diegogperoni ultrasoundandclinicalalterationsinthefootofchildrenwithobesityanddiabetes AT ferdinandofranzoni ultrasoundandclinicalalterationsinthefootofchildrenwithobesityanddiabetes AT pasqualecomberiati ultrasoundandclinicalalterationsinthefootofchildrenwithobesityanddiabetes |