Background/Purpose: Diabetes is a metabolic disease that is characterized by chronic and persistent hyperglycemia that eventually results in microvascular and macrovascular complications. These vascular complications are well evaluated, and their association with glycemia is well defined. However, little attention has been paid to the relationship between diabetes and tendinopathies still remains ulclear. We hypothesized that chronic hyperglycemia can affect morphologic or functional changes in hand tendons in type 2 diabetes. We aimed to identify whether chronic hyperglycemia can influence the morphologic changes in flexor digitorum tendons and to predict the clinial predictors of tendinopathies in patients with diabetes.

Methods: A total of 80 consecutive patients with Type 2 diabetes mellitus (T2DM; from 20 to 70 ages) and 40 age-matched controls were included. Demographics, diabetes-associated variables, carotid intima-media thickness, and data of lipid markers were collected. Serum level of malondialdehyde (MDA), and adiponectin were measured by ELISA. The morphologic changes of flexor digitorum tendons were assessed by ultrasonography. Serum samples were obtained from all the enrollee at the time point of ultrasonography study. The study was carried out at the diabetes clinic of Bucheon St. Mary’s Hospital, Catholic University of Korea, from March 2014 to April 2015. All subjects were informed and gave their written consent.

Results: Fifty-three (67%) patients with type 2 diabetes showed pathologic changes of flexor digitorum tendon, whereas only 4 (10%) subjects in control group did. The duration of diabetes tended to be longer in patients with flexor digitorum tendinopathy (FDT) compared with those without FDT. Body mass index (BMI) was significantly higher in patients with FDT than those without FDT. There was no difference in prevalence of macrovascular and microvascular complications, cholesterol profiles, HOMA-IR, and QUICKI between the the patients with FDT and those without FDT. Serum levels of adiponectin in type 2 diabetes patients with FDT were significantly lower than those of control group, but not in type 2 diabetes patients without FDT. Serum MDA levels were higher both in diabetes patients with FDT and those without FDT than controls. But, there was no difference in serum MDA level between the patients with FDT and those without FDT. Logistic regression analysis revealed that BMI, disease duration and abdominal obesity are predictor of morphologic changes of flexor digitorum tendons.

Conclusion: The morphologic changes of flexor digitorum tendons were first studied. Morphologic changes of flexor tendons in patients with type 2 diabetes might reflect the chronic burden of oxidative stress in tendons due to hyperglycemia.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/asymptomatic-tendinitis-of-flexor-digitorum-tendons-in-patients-with-type-2-diabetes-a-single-center-cross-sectional-prevalence-study/