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Journal of Diabetes Research
Volume 2017 (2017), Article ID 4749619, 12 pages
Research Article

Correlates of Calcaneal Quantitative Ultrasound Parameters in Patients with Diabetes: The Study on the Assessment of Determinants of Muscle and Bone Strength Abnormalities in Diabetes

1Department of Clinical and Molecular Medicine, “La Sapienza” University, Via di Grottarossa 1035, 00189 Rome, Italy
2Diabetes Unit, Sant’Andrea Hospital, Via di Grottarossa 1035, 00189 Rome, Italy
3Metabolic Fitness Association, Via Nomentana 27, Monterotondo, 00015 Rome, Italy
4Radiology Unit, Sant’Andrea Hospital, Via di Grottarossa 1035, 00189 Rome, Italy
5Laboratory of Clinical Chemistry, Sant’Andrea Hospital, Via di Grottarossa 1035, 00189 Rome, Italy
6Center for Outcomes Research and Clinical Epidemiology (CORESEARCH), Via Tiziano Vecellio 2, 65124 Pescara, Italy

Correspondence should be addressed to Giuseppe Pugliese

Received 2 May 2017; Revised 12 July 2017; Accepted 19 July 2017; Published 19 September 2017

Academic Editor: Bernard Portha

Copyright © 2017 Francesco Conti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. Quantitative ultrasound (QUS) provides an estimate of bone mineral density (BMD) and also evaluates bone quality, which has been related to increased fracture risk in people with diabetes. This study aimed at assessing the correlates of calcaneal QUS parameters in diabetic subjects encompassing various degrees of micro and macrovascular complications and a wide-range of peripheral nerve function. Methods. Four hundred consecutive diabetic patients were examined by QUS to obtain values of broadband ultrasound attenuation (BUA), the speed of sound (SOS), quantitative ultrasound index (QUI), and BMD. Results. Among surrogate measures of complications, sensory and motor nerve amplitude and heart rate response to cough test and standing correlated with QUS parameters at univariate analysis, together with age, body mass index (BMI), waist circumference, lipid profile, and renal function. Multivariate analysis revealed that BUA, SOS, QUI, and BMD were independently associated with age, male gender, hemoglobin A1c, BMI (or fat, but not fat-free mass), and somatic and autonomic nerve function parameters. Conclusions. These data indicate that peripheral nerve dysfunction is associated with worse QUS parameters, possibly contributing to increased fracture risk in diabetes. The positive relation of QUS measures with adiposity needs further investigation. This trial is registered with (NCT01600924).