Human Achilles tendon glycation and function in diabetes

Christian Couppé; Rene Brüggebusch Svensson; Mads Kongsgaard Madsen; Vuokko Kovanen; Jean-Francois Grosset; Ole Snorgaard; Jesper Bencke; Jytte Overgaard Larsen; Thomas Bandholm; Tomas Møller Christensen; Anders Boesen; Ida C Helmark; Per Aagaard; Michael Kjaer; Stig Peter Magnusson

doi:10.1152/japplphysiol.00547.2015

Human Achilles tendon glycation and function in diabetes

Christian Couppé, Rene Brüggebusch Svensson, Mads Kongsgaard Madsen, Vuokko Kovanen, Jean-Francois Grosset, Ole Snorgaard, Jesper Bencke, Jytte Overgaard Larsen, Thomas Bandholm, Tomas Møller Christensen, Anders Boesen, Ida C Helmark, Per Aagaard, Michael Kjaer, Stig Peter Magnusson

38 Citations (Scopus)

Abstract

Diabetic patients have an increased risk of foot ulcers, and glycation of collagen may increase tissue stiffness. We hypothesized that the level of glycemic control (glycation) may affect Achilles tendon stiffness, which can influence gait pattern. We therefore investigated the relationship between collagen glycation, Achilles tendon stiffness parameters, and plantar pressure in poorly (n = 22) and well (n = 22) controlled diabetic patients, including healthy age-matched (45-70 yr) controls (n = 11). There were no differences in any of the outcome parameters (collagen cross-linking or tendon stiffness) between patients with well-controlled and poorly controlled diabetes. The overall effect of diabetes was explored by collapsing the diabetes groups (DB) compared with the controls. Skin collagen cross-linking lysylpyridinoline, hydroxylysylpyridinoline (136%, 80%, P < 0.01) and pentosidine concentrations (55%, P < 0.05) were markedly greater in DB. Furthermore, Achilles tendon material stiffness was higher in DB (54%, P < 0.01). Notably, DB also demonstrated higher forefoot/rearfoot peak-plantar-pressure ratio (33%, P < 0.01). Overall, Achilles tendon material stiffness and skin connective tissue cross-linking were greater in diabetic patients compared with controls. The higher foot pressure indicates that material stiffness of tendon and other tissue (e.g., skin and joint capsule) may influence foot gait. The difference in foot pressure distribution may contribute to the development of foot ulcers in diabetic patients.

Original language	English
Journal	Journal of Applied Physiology
Volume	120
Issue number	2
Pages (from-to)	130-137
Number of pages	8
ISSN	8750-7587
DOIs	https://doi.org/10.1152/japplphysiol.00547.2015
Publication status	Published - 15 Jan 2016

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Couppé, C., Svensson, R. B., Madsen, M. K., Kovanen, V., Grosset, J.-F., Snorgaard, O., Bencke, J., Larsen, J. O., Bandholm, T., Christensen, T. M., Boesen, A., Helmark, I. C., Aagaard, P., Kjaer, M., & Magnusson, S. P. (2016). Human Achilles tendon glycation and function in diabetes. Journal of Applied Physiology, 120(2), 130-137. https://doi.org/10.1152/japplphysiol.00547.2015

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title = "Human Achilles tendon glycation and function in diabetes",

abstract = "Diabetic patients have an increased risk of foot ulcers, and glycation of collagen may increase tissue stiffness. We hypothesized that the level of glycemic control (glycation) may affect Achilles tendon stiffness, which can influence gait pattern. We therefore investigated the relationship between collagen glycation, Achilles tendon stiffness parameters, and plantar pressure in poorly (n = 22) and well (n = 22) controlled diabetic patients, including healthy age-matched (45-70 yr) controls (n = 11). There were no differences in any of the outcome parameters (collagen cross-linking or tendon stiffness) between patients with well-controlled and poorly controlled diabetes. The overall effect of diabetes was explored by collapsing the diabetes groups (DB) compared with the controls. Skin collagen cross-linking lysylpyridinoline, hydroxylysylpyridinoline (136%, 80%, P < 0.01) and pentosidine concentrations (55%, P < 0.05) were markedly greater in DB. Furthermore, Achilles tendon material stiffness was higher in DB (54%, P < 0.01). Notably, DB also demonstrated higher forefoot/rearfoot peak-plantar-pressure ratio (33%, P < 0.01). Overall, Achilles tendon material stiffness and skin connective tissue cross-linking were greater in diabetic patients compared with controls. The higher foot pressure indicates that material stiffness of tendon and other tissue (e.g., skin and joint capsule) may influence foot gait. The difference in foot pressure distribution may contribute to the development of foot ulcers in diabetic patients.",

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AU - Couppé, Christian

AU - Svensson, Rene Brüggebusch

AU - Madsen, Mads Kongsgaard

AU - Kovanen, Vuokko

AU - Grosset, Jean-Francois

AU - Snorgaard, Ole

AU - Bencke, Jesper

AU - Larsen, Jytte Overgaard

AU - Bandholm, Thomas

AU - Christensen, Tomas Møller

AU - Boesen, Anders

AU - Helmark, Ida C

AU - Aagaard, Per

AU - Kjaer, Michael

AU - Magnusson, Stig Peter

PY - 2016/1/15

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N2 - Diabetic patients have an increased risk of foot ulcers, and glycation of collagen may increase tissue stiffness. We hypothesized that the level of glycemic control (glycation) may affect Achilles tendon stiffness, which can influence gait pattern. We therefore investigated the relationship between collagen glycation, Achilles tendon stiffness parameters, and plantar pressure in poorly (n = 22) and well (n = 22) controlled diabetic patients, including healthy age-matched (45-70 yr) controls (n = 11). There were no differences in any of the outcome parameters (collagen cross-linking or tendon stiffness) between patients with well-controlled and poorly controlled diabetes. The overall effect of diabetes was explored by collapsing the diabetes groups (DB) compared with the controls. Skin collagen cross-linking lysylpyridinoline, hydroxylysylpyridinoline (136%, 80%, P < 0.01) and pentosidine concentrations (55%, P < 0.05) were markedly greater in DB. Furthermore, Achilles tendon material stiffness was higher in DB (54%, P < 0.01). Notably, DB also demonstrated higher forefoot/rearfoot peak-plantar-pressure ratio (33%, P < 0.01). Overall, Achilles tendon material stiffness and skin connective tissue cross-linking were greater in diabetic patients compared with controls. The higher foot pressure indicates that material stiffness of tendon and other tissue (e.g., skin and joint capsule) may influence foot gait. The difference in foot pressure distribution may contribute to the development of foot ulcers in diabetic patients.

AB - Diabetic patients have an increased risk of foot ulcers, and glycation of collagen may increase tissue stiffness. We hypothesized that the level of glycemic control (glycation) may affect Achilles tendon stiffness, which can influence gait pattern. We therefore investigated the relationship between collagen glycation, Achilles tendon stiffness parameters, and plantar pressure in poorly (n = 22) and well (n = 22) controlled diabetic patients, including healthy age-matched (45-70 yr) controls (n = 11). There were no differences in any of the outcome parameters (collagen cross-linking or tendon stiffness) between patients with well-controlled and poorly controlled diabetes. The overall effect of diabetes was explored by collapsing the diabetes groups (DB) compared with the controls. Skin collagen cross-linking lysylpyridinoline, hydroxylysylpyridinoline (136%, 80%, P < 0.01) and pentosidine concentrations (55%, P < 0.05) were markedly greater in DB. Furthermore, Achilles tendon material stiffness was higher in DB (54%, P < 0.01). Notably, DB also demonstrated higher forefoot/rearfoot peak-plantar-pressure ratio (33%, P < 0.01). Overall, Achilles tendon material stiffness and skin connective tissue cross-linking were greater in diabetic patients compared with controls. The higher foot pressure indicates that material stiffness of tendon and other tissue (e.g., skin and joint capsule) may influence foot gait. The difference in foot pressure distribution may contribute to the development of foot ulcers in diabetic patients.

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DO - 10.1152/japplphysiol.00547.2015

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SN - 8750-7587

VL - 120

SP - 130

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JO - Journal of Applied Physiology

JF - Journal of Applied Physiology

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ER -

Human Achilles tendon glycation and function in diabetes

Abstract

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