Evaluation of Shear Stress in the Popliteal Artery in Patients With Type 2 Diabetes Mellitus Using Vascular Sonography

The aim of this study was to use vascular sonography to evaluate the dynamic forces acting on the wall of the popliteal artery in patients with type 2 diabetes mellitus (T2DM) compared to a control group without diabetes. Forty patients with T2DM and 20 control subjects were enrolled in the study. Patients were divided according to their measured Ankle-Brachial Index (ABI) into two groups, those with evidence of peripheral vascular disease (PVD) based on an ABI < 0.9 (n = 18) and those without peripheral vascular disease (N-PVD, ABI ≥ 0.9, n = 22). The systolic and diastolic internal diameter (IDs, IDd) and the end-diastolic intima media thickness (IMT) of the popliteal artery were measured. Hemodynamic parameters measured were the peak systolic velocity, end-diastolic velocity, and the mean velocity (Vs, Vd, Vm). The peak systolic and mean shear stress (Ts, Tm) were calculated using the Hagen-Poiseuille formula. The shear stress of the popliteal artery was significantly decreased in patients with diabetes in the PVD group compared to the N-PVD group ( P < .05). Shear stress also was significantly decreased in both the N-PVD and the PVD patients compared to the control group ( P < .05). The shear stress may be a reliable index for the assessment of lower extremity arterial disease status in patients with diabetes mellitus at an early stage when the vascular IMT remains normal.