Correlates of the Ultrasonographic and Elastosonographic Parameters of the Plantar Fascia in Patients with Type 2 Diabetes

Background. Prevalence of plantar fasciitis is increased in type 2 diabetes. This study was aimed at assessing the correlates of ultrasonographic and elastosonographic parameters in plantar fascia (PF) individuals with type 2 diabetes encompassing vari-ous degrees of complications.Methods. This cross-sectional study included 98 patients with type 2 diabetes. Thick-ness of PF was assessed by ultrasonography, whereas elasticity of hard tissue (Elx-Hrd) at PF insertion and course and the subcutaneous-to-insertional strain ratio (Elx 2/1) were determined by elastosonography.Results. No significant differences were detected according to age category, sex, phys-ical activity, and presence of complications, except for higher Elx-Hrd insertion and Elx 1/2 in participants with cardiac autonomic neuropathy (CAN). Thickness of PF, Elx-Hrd insertion and Elx 1/2 correlated significantly with BMI, waist circumference, fat-free mass, and parameters of peripheral neuropathy and CAN; BMI, waist circum-ference, fat mass, fat-free mass, and CAN were independently associated with PF thickness, Elx-Hrd insertion, and Elx 1/2.Conclusions. Adiposity, body composition and presence of CAN are the main correlates of PF ultrasonographic and elastosonographic parameters, suggesting that body weight reduction, maintenance of muscle mass, and prevention of neuropathic complications may result in a decreased incidence of plantar fasciitis in individuals with type 2 diabetes.Study registration. Study registered with ClinicalTrial.gov, NCT01600924 at https:// clinicaltrials.gov/ct2/show/NCT01600924.