The Structural Effects of Diabetes on Soft Tissues: A Systematic Review.

Q3 Engineering Critical Reviews in Biomedical Engineering Pub Date : 2021-01-01 DOI:10.1615/CritRevBiomedEng.2022043200

Shunafrica White, Matthew B A McCullough, Paul M Akangah

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Abstract

Hyperglycemia, which is associated with diabetes, increases the production of advanced glycation end products. Advanced glycation end products lead to the structural degradation of soft tissues. The structural degradation of diabetic soft tissues has been investigated in humans, rodents, and canines. Therefore, the objective of this review is to unify the various contributions to diabetes research through the mechanical properties and geometric characteristics of soft tissues. A systematic review was performed and identified the effects of diabetes on mechanical and geometric properties of soft tissues via experimental testing or in vivo - driven finite element analysis. The literature concludes that diabetes contributes to major structural changes in soft tissues but does not cause the same structural changes in all soft tissues (e.g., diabetic tendons are weaker and diabetic plantar tissues are tougher). Diabetes stiffens and toughens soft tissues, thus altering viscoelastic behavior (e.g., poor strain and stress response). However, diabetes management routines can prevent or minimize the effects of diabetes on the mechanical and geometric properties of soft tissues. Unification of the structural effects of diabetes on soft tissues will contribute to the pathophysiology of diabetes.

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糖尿病对软组织的结构性影响:系统综述。

与糖尿病相关的高血糖症会增加晚期糖基化终产物的产生。晚期糖基化终产物导致软组织的结构降解。糖尿病软组织的结构降解已经在人类、啮齿动物和犬科动物中进行了研究。因此，本综述的目的是通过软组织的力学特性和几何特征来统一各种对糖尿病研究的贡献。通过实验测试或体内驱动的有限元分析，进行了系统回顾并确定了糖尿病对软组织力学和几何特性的影响。文献得出的结论是，糖尿病会导致软组织的主要结构变化，但并不是所有软组织的结构变化都相同(例如，糖尿病肌腱变弱，糖尿病足底组织变硬)。糖尿病使软组织变硬和变韧，从而改变粘弹性行为(例如，应变和应力反应差)。然而，糖尿病常规管理可以预防或尽量减少糖尿病对软组织力学和几何特性的影响。统一糖尿病对软组织的结构性影响将有助于糖尿病的病理生理。

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来源期刊

Critical Reviews in Biomedical Engineering Engineering-Biomedical Engineering

CiteScore

1.80

自引率

0.00%

发文量

期刊介绍： Biomedical engineering has been characterized as the application of concepts drawn from engineering, computing, communications, mathematics, and the physical sciences to scientific and applied problems in the field of medicine and biology. Concepts and methodologies in biomedical engineering extend throughout the medical and biological sciences. This journal attempts to critically review a wide range of research and applied activities in the field. More often than not, topics chosen for inclusion are concerned with research and practice issues of current interest. Experts writing each review bring together current knowledge and historical information that has led to the current state-of-the-art.