Li QS, Xiao XH, Cai YY, Xiao XP, Hu PX, Li H. First metatarsophalangeal joint synovial hypertrophy associated with vitamin D status in type 2 diabetes mellitus: An ultrasound-graded study. World J Diabetes 2025; 16(7): 107019 [DOI: 10.4239/wjd.v16.i7.107019]
Corresponding Author of This Article
Hong Li, MD, Doctor, Professor, Department of Ultrasound, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), No. 1 Fuhua Road, Futian District, Shenzhen 518000, Guangdong Province, China. lihong_echo@163.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Jul 15, 2025; 16(7): 107019 Published online Jul 15, 2025. doi: 10.4239/wjd.v16.i7.107019
First metatarsophalangeal joint synovial hypertrophy associated with vitamin D status in type 2 diabetes mellitus: An ultrasound-graded study
Qing-Shan Li, Xiao-Hui Xiao, Yu-Ying Cai, Xiao-Peng Xiao, Ping-Xiang Hu, Hong Li
Qing-Shan Li, Yu-Ying Cai, Xiao-Peng Xiao, Ping-Xiang Hu, Hong Li, Department of Ultrasound, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), Shenzhen 518000, Guangdong Province, China
Xiao-Hui Xiao, Department of Endocrinology, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), Shenzhen 518000, Guangdong Province, China
Co-corresponding authors: Ping-Xiang Hu and Hong Li.
Author contributions: Li QS contributed to image acquisition and analysis, writing original draft; Xiao XH contributed to collect clinical and laboratory data; Cai YY contributed to data curation, formal analysis; Xiao XP contributed to image quality supervision and image analysis; Hu PX contributed to project administration; Li H contributed to writing review and editing; All authors participated in the discussion of the manuscript and agreed on the content and publication of the final manuscript.
Institutional review board statement: This study was approved by the Shenzhen Traditional Chinese Medicine Hospital Ethics Committee (No. K2023/098/02) and adhered to the principles outlined in the Declaration of Helsinki.
Informed consent statement: All participants provided written informed consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong Li, MD, Doctor, Professor, Department of Ultrasound, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), No. 1 Fuhua Road, Futian District, Shenzhen 518000, Guangdong Province, China. lihong_echo@163.com
Received: March 17, 2025 Revised: April 26, 2025 Accepted: June 19, 2025 Published online: July 15, 2025 Processing time: 124 Days and 6.9 Hours
Core Tip
Core Tip: This study refines a semi-quantitative ultrasound grading system for first metatarsophalangeal joint synovial hypertrophy by introducing a novel subtype that specifically classifies cases of dorsal recess overlying the metatarsal bone, demonstrating high reliability (intra-observer intraclass correlation coefficient = 0.79; inter-observer intraclass correlation coefficient = 0.73). We identified a significant inverse, non-linear correlation between serum 25-hydroxyvitamin D levels and synovial hypertrophy severity, with a threshold effect at 23.8 ng/mL. These findings suggest that vitamin D deficiency may contribute to synovial inflammation in type 2 diabetes mellitus patients and that targeted screening and supplementation could help mitigate joint complications.
