Muscle volume loss may progress in parallel with muscle-associated adipose tissue (MAAT) accumulation, impacting contractile performance in individuals with diabetic peripheral neuropathy (DPN), according to an article recently published in the journal Gait & Posture.
Researchers from Washington University in St. Louis, Missouri, wanted to understand the muscle quality (normal, abnormal muscle, and adipose volumes) of the DPN foot intrinsic compartment, how it changes over time, and whether muscle quality is related to gait and foot function.
In their study, 45 patients with DPN (mean age 67 yrs) had computed tomography (CT) performed on the intrinsic foot muscle compartment; the CT was repeated at approximately 3.6 years. Each time, images were processed to obtain volumes of MAAT, highly abnormal, mildly abnormal, and normal muscle. Annual rates of change were calculated for each category and paired t-tests were conducted at baseline and follow-up. 3D motion analysis and the Foot and Ankle Ability Measure (FAAM) were used to assess foot function, and Pearson’s correlations were used to analyze correlations between muscle compartment and foot function during gait.
The researchers reported that total muscle volume decreased, driven by a loss of normal muscle and mildly abnormal muscle (P < 0.05). MAAT and the adipose-muscle ratio increased. At baseline, 51.5% of the compartment was abnormal muscle or MAAT, increasing to 55.0% at follow-up. Decreased total muscle volume correlated with greater midfoot collapse during gait (r = -0.40, P = 0.02). Greater volumes of highly abnormal muscle correlated with a lower FAAM score (r = -0.33, P = 0.03).
In other words, patients with DPN showed impaired muscle quality that worsened over time.
The authors concluded that muscle quality, not adipose tissue, is related to foot function during gait. Muscle volume loss may progress in parallel with MAAT accumulation, impacting contractile performance in individuals with DPN. Only 48.5% of the DPN intrinsic foot muscle compartment consists of normal muscle and greater abnormal muscle is associated with worse foot function. These changes identify an important target for rehabilitative intervention to slow or prevent muscle deterioration and poor foot outcomes.
Source: Kaszyk EM, Commean PK, Meyer GA, et al. Use of computed tomography to identify muscle quality subgroups, spatial mapping, and preliminary relationships to function in those with diabetic peripheral neuropathy. Gait Posture. 2024 Jul;112:159-166. doi: 10.1016/j.gaitpost.2024.05.016.
