{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:13:51Z","timestamp":1783509231962,"version":"3.55.0"},"reference-count":90,"publisher":"MDPI AG","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Metabolic disorders are known to alter the mechanical properties of tendons. We sought to evaluate the prevalence of asymptomatic Achilles tendon enthesopathic changes in patients with type 2 diabetes mellitus (T2DM) without peripheral neuropathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We recruited 43 patients with T2DM and 40 controls. Neuropathy was excluded with the Michigan Neuropathy Scoring Instrument. Bilateral ultrasonography of the Achilles tendon enthesis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Patients with T2DM had a higher prevalence of hypoechogenicity (26.7% versus 2.5%; P = .0001), entheseal thickening (24.4% versus 8.7%; P = .007), and enthesophytes (74.4% versus 57.5%; P = .02). No differences were found in the number of patients with erosions (1.2% versus 0%; P &amp;gt; .99), cortical irregularities (11.6% versus 3.7%; P = .09), bursitis (5.8% versus 3.7%; P = .72), or tears (2.3% versus 1.2%; P &amp;gt; .99). The mean \u00b1 SD sum of abnormalities was higher in patients with T2DM (1.5 \u00b1 1.1 versus 0.7 \u00b1 0.6; P &amp;lt; .0001), as was the percentage of bilateral involvement (72.1% versus 45.0%; P = .01). Mean \u00b1 SD thickness did not differ between patients and controls (4.4 \u00b1 1.1 mm versus 4.2 \u00b1 0.8 mm; P = .07).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>According to our data, there is an elevated prevalence of asymptomatic Achilles tendon enthesopathic changes in patients with T2DM independent of peripheral neuropathy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7547\/16-059","type":"journal-article","created":{"date-parts":[[2016,10,10]],"date-time":"2016-10-10T16:18:46Z","timestamp":1476116326000},"page":"99-105","source":"Crossref","is-referenced-by-count":20,"title":["High Prevalence of Achilles Tendon Enthesopathic Changes in Patients with Type 2 Diabetes Without Peripheral Neuropathy"],"prefix":"10.3390","volume":"107","author":[{"given":"Francesco","family":"Ursini","sequence":"first","affiliation":[{"name":"Department of Health Sciences, University of Catanzaro \u201cMagna Graecia,\u201d Catanzaro, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Arturi","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences, University of Catanzaro \u201cMagna Graecia,\u201d Catanzaro, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"D'Angelo","sequence":"first","affiliation":[{"name":"Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewa","family":"Amara","sequence":"first","affiliation":[{"name":"Department of Health Sciences, University of Catanzaro \u201cMagna Graecia,\u201d Catanzaro, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kassandra","family":"Nicolosi","sequence":"first","affiliation":[{"name":"Department of Health Sciences, University of Catanzaro \u201cMagna Graecia,\u201d Catanzaro, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Russo","sequence":"first","affiliation":[{"name":"Department of Health Sciences, University of Catanzaro \u201cMagna Graecia,\u201d Catanzaro, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saverio","family":"Naty","sequence":"first","affiliation":[{"name":"Department of Health Sciences, University of Catanzaro \u201cMagna Graecia,\u201d Catanzaro, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Bruno","sequence":"first","affiliation":[{"name":"Department of Health Sciences, University of Catanzaro \u201cMagna Graecia,\u201d Catanzaro, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovambattista","family":"De Sarro","sequence":"first","affiliation":[{"name":"Department of Health Sciences, University of Catanzaro \u201cMagna Graecia,\u201d Catanzaro, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignazio","family":"Olivieri","sequence":"first","affiliation":[{"name":"Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa Daniela","family":"Grembiale","sequence":"first","affiliation":[{"name":"Department of Health Sciences, University of Catanzaro \u201cMagna Graecia,\u201d Catanzaro, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"ref801","doi-asserted-by":"crossref","first-page":"e74942","DOI":"10.1371\/journal.pone.0074942","article-title":"Experimental diabetes induces structural, inflammatory and vascular changes of Achilles tendons","volume":"8","author":"de Oliveira","year":"2013","journal-title":"PLoS 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matrix stiffness in rabbit achilles tendon","volume":"5","author":"Reddy","year":"2004","journal-title":"Exp Diabesity Res"},{"key":"ref141","doi-asserted-by":"crossref","first-page":"e91234","DOI":"10.1371\/journal.pone.0091234","article-title":"Tendon repair is compromised in a high fat diet-induced mouse model of obesity and type 2 diabetes","volume":"9","author":"David","year":"2014","journal-title":"PLoS One"},{"key":"ref821","doi-asserted-by":"crossref","first-page":"1880","DOI":"10.1007\/s10439-014-1031-7","article-title":"Diabetes alters mechanical properties and collagen fiber re-alignment in multiple mouse tendons","volume":"42","author":"Connizzo","year":"2014","journal-title":"Ann Biomed Eng"},{"key":"ref161","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1055\/s-0029-1224121","article-title":"Achilles tendon volume in type 2 diabetic patients with or without peripheral neuropathy: MRI study","volume":"117","author":"Papanas","year":"2009","journal-title":"Exp 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