Objective To investigate the clinical value of high frequency ultrasound and shear wave elastography（SWE）combined with clinical indicators in the evaluation of tibial neuropathy risk in type 2 diabetic patients.MethodsSeventy-two cases of diabetes

including 34 cases of peripheral neuropathy（DPN group）and 38 cases of non-peripheral neuropathy（NDPN group）were enrolled in this study.Data of gender

age

disease course

body mass index（BMI）

glycosylated hemoglobin（Hb A1 c）

serum insulin-like growth factor-1（IGF-1）

plasma homocysteine（Hcy）

left-right diameter

the anterior-posteriordiameter

cross-sectional area and elasticity measured by shear wave elastography were collected and compared between the twogroups.The correlation between ultrasonic parameters and laboratory indexes was analyzed.Multivariate analysis of clinical data

laboratory indicators

ultrasound parameters

and quantitative scoring of the results.ResultsThe age

disease course in the DPNgroup were higher than those of the NDPN group（both P<0.05）

the gender and BMI were not statistically significant between thetwo groups. In the DPN group

the left-right diameter

the anterior-posterior diameter

CSA

the elastic modulus of the tibialnerve

Hb A1 c and Hcy were higher than those of the NDPN group

while the IGF-1 was lower than that of the NDPN group（allP<0.05）.Hcy and Hb A1 c were positively correlated with the tibial nerve diameter

CSA and elastic modulus of tibial nerve（r=0.339

0.288

0.351

0.257

0.246

0.192

all P<0.05）

while IGF-1 was negatively correlated with anterior-posterior diameterand CSA（r=-0.406

-0.334

both P<0.05）.Multi-factor analysis results showed that disease course

CSA

the elastic modulus

Hb A1 c were independent risk factors for DPN（OR=3.267

1.925

1.117

3.542

all P<0.05）

while IGF-1 was a protective factor（OR=0.892

P=0.004）. The nomogram results showed a score of up to 180 points for a 70% risk of peripheral neuropathy.ConclusionHigh frequency ultrasound and SWE combined with clinical indicators is potentially used to evaluate tibialneuropathy for patients with diabetes mellitus

among them

the increase in disease course

CSA

the elastic modulus

and Hb A1 care independent risk factors to evaluate tibial neuropathy

while the increase in IGF-1 is a protective factor.