Vitamin D replasmanın huzursuz bacaklar sendromunda hastalık semptomları, uyku, depresyon ve yorgunluk üzerine etkileri
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Geçmişte yapılan araştırmalar, Huzursuz Bacak Sendromu hastalarında D vitamini eksikliğinin daha sık görüldüğünü ve D vitamini eksik olan hastalarda bu semptomların daha ciddi olduğunu ortaya koymuştur. Çalışmamızın amacı, Huzursuz bacaklar tanısı olan ve Vitamin D eksiliği saptanan hastalarda, D vitamini takviyesi öncesi ve sonrası UHBSSG çalışma grubu semptom skalası, Yorgunluk Şiddet Ölçeği, Beck Depresyon Ölçeği ve Pittsbug Uyku Kalite İndeksi gibi ölçümleri kullanarak, Vitamin D replasman tedavisinin hastaların semptomları üzerindeki etkisini değerlendirmektir. Gereç ve yöntem: Ocak 2022 ile Nisan 2023 tarihleri arasında Düzce Üniversitesi Tıp Fakültesi Nöroloji Polikliniği'ne Huzursuz Bacaklar Sendromu tanısı ile başvuran hastaların dosyaları taranmıştır. Bu nedenle, kliniğimizde Huzursuz Bacaklar Sendromu tanısı konulan hastaların D vitamini düzeyleri de incelenmiş ve eksik olan hastalara replasman tedavisi uygulanmıştır. D vitamini takviyesinin, Huzursuz Bacaklar Sendromu semptomları üzerine etkileri UHBSSG çalışma grubu semptom skalası, yorgunluk düzeyi üzerine etkileri Yorgunluk Şiddet Ölçeği, depresyon seviyesi üzerine etkileri Beck Depresyon Ölçeği ve uyku kalitesi üzerine etkileri Pittsbug Uyku Kalite İndeksi ile değerlendirilmiştir. Çalışmanın örneklemi, D vitamini eksikliği olan idiyopatik HBS hastalarından oluşmuştur. Başvuru sırasındaki ölçümler alındıktan sonra, D vitamini yetmezliği saptanan hastalara haftalık 50.000 IU 3 ay boyunca replasman yapılmıştır. Replasman sonrası 3. ayda hastaların kontrol D vitamini düzeyleri ölçülmüş ve aynı ölçüm araçları tekrar kullanılmıştır. D vitamini düzeyi normal aralığa gelmemiş olan hastalar 3. ayda çalışmadan çıkarılmıştır. Tedavi süreci boyunca düzenli kontroller yapılarak hastaların durumları gözlemlenmiştir. Çalışma tamamlandığında, D vitamini tedavisi öncesi ve sonrasındaki durumlar arasında yapılan karşılaştırmalar sonucunda, D vitamini replasman tedavisinin hastalık semptomlarının şiddeti, uyku kalitesi, depresyon ve yorgunluk üzerindeki etkisine dair sonuçlar elde edilmiştir. Bulgular: Çalışmaya katılan 25 hastanın başlangıçtaki BDÖ değerleri incelendiğinde, en düşük değerin 0 ve en yüksek değerin 22 olduğu görüldü. Başlangıçtaki ortalama BDÖ değeri ise 6,80 ± SS 5,64 olarak hesaplandı. 3 ay süren D vitamini replasman tedavisi sonrasında hastaların BDÖ değerleri tekrar ölçüldü. Bu ölçümlere göre en düşük değer yine 0, en yüksek değer ise 23 olarak belirlendi. Tedavi sonrası ortalama BDÖ değeri ise 6,84 ± SS 5,91 olarak hesaplandı. Giriş ve 3. Ay BDÖ skorları karşılaştırıldığında istatistiksel anlamlı değişiklik saptanmadı (p= 0,846). Bu sonuçlar, D vitamini replasman tedavisi sonrasında hastaların depresyon düzeylerinde önemli bir değişiklik olmadığını göstermektedir. Çalışmaya katılan 25 hastanın başlangıçtaki UHBSÇGŞÖ skoları incelendiğinde, en düşük değerin 5 ve en yüksek değerin 29 olduğu görüldü. Başlangıçtaki ortalama UHBSÇGŞÖ skoru ise 15,36 ± SS 6,75 olarak hesaplandı. 3 ay süren D vitamini replasman tedavisi sonrasında hastaların UHBSÇGŞÖ skorları tekrar ölçüldü. Bu ölçümlere göre en düşük değer 5, en yüksek değer ise 29 olarak ölçüldü. Tedavi sonrası ortalama UHBSÇGŞÖ skoru ise 14,28 ± SS 6,22 olarak hesaplandı. Replasman tedavisi sonrası UHBSÇGŞÖ skorları girişe göre istatistiksel anlamlı düşüktü (p=0,019). Çalışmaya katılan 25 hastanın başlangıçtaki PUKİ skorları incelendiğinde, en düşük değerin 9 ve en yüksek değerin 17 olduğu görüldü. Başlangıçtaki ortalama PUKİ skoru ise 11,76 ±SS 1,98 idi. D vitamini replasman tedavisi sonrasında hastaların PUKİ skorları ise en düşük değer 7, en yüksek değer ise 17 olarak belirlendi. Tedavi sonrası ortalama PUKİ skoru ise 11,52 ± SS 2,30 idi. Giriş ve 3. ay PUKİ skorları arasında istatistiksel anlamlı fark saptanmadı (p=0,242). Çalışmada yer alan 25 hastanın başlangıçtaki YŞÖ skorları analiz edildiğinde, en düşük değer 1 ve en yüksek değer 55 olarak ölçüldü. Başlangıçtaki ortalama YŞÖ skoru ise 19,32 ±SS 12,34 olarak hesaplandı. 3 aylık D vitamini replasman tedavisi sonrasında hastaların YŞÖ skorları tekrar değerlendirildi. Bu ölçümlere göre en düşük değer 1, en yüksek değer ise 55 olarak tespit edildi. Tedavi sonrası ortalama YŞÖ skoru ise 18,24 ±SS 11,32 olarak belirlendi. Giriş ve 3. ay YŞÖ skorları karşılaştırıldığında 3. ay YŞÖ skorları girişe göre hafifçe azalmıştı. İstatiksel anlamlılık sağlanmasa da p =0,058 idi ve anlamlılığa yakın bir düşüş saptanmıştı. Sonuç: D vitamini replasmanının HBS semptom şiddetinde olumlu etki sağladığını gösterirken, uyku kalitesi ve depresyon üzerinde anlamlı bir etkisi olmadığını ortaya koymuştur. Yorgunluk düzeylerinde ise sınırlı bir etki gözlemlenmiştir. İdyopatik HBS hastalarında D vitamini düzeyi hastalık semptom şiddeti ile ilişkili gibi görünmektedir. HBS hastalarında D vitamini düzeyinin bakılmasının ve eksik olan hastalarda replasman yapılmasının hastalık semptomlarının şiddetini azaltacağını düşündürmektedir. Anahtar Sözcükler: Huzursuz Bacaklar Sendromu, Vitamin D, Depresyon, Yorgunluk, Uyku kalitesi.
Objective: Previous research has shown that vitamin D deficiency is more common in patients with Restless Legs Syndrome (RLS) and that symptoms are more severe in those with vitamin D deficiency. The aim of our study is to evaluate the effect of vitamin D replacement therapy on patients' symptoms by using measurements such as the International Restless Legs Syndrome Study Group (IRLSSG) symptom scale, Fatigue Severity Scale, Beck Depression Inventory, and Pittsburgh Sleep Quality Index in patients diagnosed with restless legs and found to have vitamin D deficiency before and after vitamin D supplementation. Materials and methods: Between January 2022 and April 2023, the medical records of patients who applied to the Duzce University Faculty of Medicine Neurology Outpatient Clinic with a diagnosis of Restless Legs Syndrome (RLS) were reviewed. Consequently, the vitamin D levels of patients diagnosed with RLS in our clinic were examined, and replacement therapy was administered to those with deficiencies. The effects of vitamin D supplementation on RLS symptoms were assessed using the International Restless Legs Syndrome Study Group (IRLSSG) symptom scale, the Fatigue Severity Scale for effects on fatigue levels, the Beck Depression Inventory for effects on depression levels, and the Pittsburgh Sleep Quality Index for effects on sleep quality. The study sample consisted of idiopathic RLS patients with vitamin D deficiency. After taking measurements at the time of application, patients with detected vitamin D deficiency received a weekly 50.000 IU replacement for three months. At the end of the third month after replacement, patients' control vitamin D levels were measured, and the same measurement tools were used again. Patients whose vitamin D levels did not reach the normal range were excluded from the study in the third month. Patients' conditions were observed with regular checks throughout the treatment process. Upon completion of the study, comparisons were made between the conditions before and after vitamin D therapy. Results were obtained regarding the effect of vitamin D replacement therapy on the severity of disease symptoms, sleep quality, depression, and fatigue. Results: Upon examining the initial Beck Depression Inventory (BDI) scores of the 25 patients participating in the study, the lowest score was found to be 0 and the highest score was 22. The initial average BDI score was calculated as 6.80 ± SD 5.64. After the 3-month vitamin D replacement therapy, patients' BDI scores were measured again. According to these measurements, the lowest score remained 0, and the highest score was determined to be 23. The post-treatment average BDI score was calculated as 6.84 ± SD 5.91. No statistically significant change was detected when comparing the baseline and 3-month BDI scores (p = 0.846). These results indicate that there was no significant change in patients' depression levels after vitamin D replacement therapy. Upon examining the initial International Restless Legs Syndrome Study Group (IRLSSG) symptom scale scores of the 25 patients participating in the study, the lowest score was found to be 5 and the highest score was 29. The initial average IRLSSG symptom scale score was calculated as 15.36 ± SD 6.75. After the 3-month vitamin D replacement therapy, patients' IRLSSG symptom scale scores were measured again. According to these measurements, the lowest score was 5 and the highest score remained 29. The post-treatment average IRLSSG symptom scale score was calculated as 14.28 ± SD 6.22. The IRLSSG symptom scale scores after replacement therapy were significantly lower compared to baseline (p = 0.019). Upon examining the initial Pittsburgh Sleep Quality Index (PSQI) scores of the 25 patients participating in the study, the lowest score was found to be 9 and the highest score was 17. The initial average PSQI score was 11.76 ± SD 1.98. After the vitamin D replacement therapy, patients' PSQI scores were determined to have a minimum value of 7 and a maximum value of 17. The post-treatment average PSQI score was 11.52 ± SD 2.30. There was no statistically significant difference between the baseline and 3-month PSQI scores (p = 0.242). When analyzing the initial Fatigue Severity Scale (FSS) scores of the 25 patients participating in the study, the lowest score was measured to be 1 and the highest score was 55. The initial average FSS score was calculated as 19.32 ± SD 12.34. After the 3-month vitamin D replacement therapy, patients' FSS scores were re-evaluated. According to these measurements, the lowest score was 1, and the highest score remained 55. The post-treatment average FSS score was determined as 18.24 ± SD 11.32. When comparing the baseline and 3-month FSS scores, the 3-month FSS scores were slightly decreased compared to baseline. Although statistical significance was not achieved, p = 0.058 indicated a decrease close to significance. Conclusion: Vitamin D replacement therapy has been shown to have a positive effect on the severity of RLS symptoms, while it did not have a significant effect on sleep quality and depression. A limited effect on fatigue levels was observed. Vitamin D levels in idiopathic RLS patients seem to be associated with the severity of disease symptoms. Monitoring vitamin D levels in RLS patients and administering replacement therapy in those with deficiencies may suggest a reduction in the severity of disease symptoms. Keywords: Restless Legs Syndrome, Vitamin D, Depression, Fatigue, Sleep Quality.
Objective: Previous research has shown that vitamin D deficiency is more common in patients with Restless Legs Syndrome (RLS) and that symptoms are more severe in those with vitamin D deficiency. The aim of our study is to evaluate the effect of vitamin D replacement therapy on patients' symptoms by using measurements such as the International Restless Legs Syndrome Study Group (IRLSSG) symptom scale, Fatigue Severity Scale, Beck Depression Inventory, and Pittsburgh Sleep Quality Index in patients diagnosed with restless legs and found to have vitamin D deficiency before and after vitamin D supplementation. Materials and methods: Between January 2022 and April 2023, the medical records of patients who applied to the Duzce University Faculty of Medicine Neurology Outpatient Clinic with a diagnosis of Restless Legs Syndrome (RLS) were reviewed. Consequently, the vitamin D levels of patients diagnosed with RLS in our clinic were examined, and replacement therapy was administered to those with deficiencies. The effects of vitamin D supplementation on RLS symptoms were assessed using the International Restless Legs Syndrome Study Group (IRLSSG) symptom scale, the Fatigue Severity Scale for effects on fatigue levels, the Beck Depression Inventory for effects on depression levels, and the Pittsburgh Sleep Quality Index for effects on sleep quality. The study sample consisted of idiopathic RLS patients with vitamin D deficiency. After taking measurements at the time of application, patients with detected vitamin D deficiency received a weekly 50.000 IU replacement for three months. At the end of the third month after replacement, patients' control vitamin D levels were measured, and the same measurement tools were used again. Patients whose vitamin D levels did not reach the normal range were excluded from the study in the third month. Patients' conditions were observed with regular checks throughout the treatment process. Upon completion of the study, comparisons were made between the conditions before and after vitamin D therapy. Results were obtained regarding the effect of vitamin D replacement therapy on the severity of disease symptoms, sleep quality, depression, and fatigue. Results: Upon examining the initial Beck Depression Inventory (BDI) scores of the 25 patients participating in the study, the lowest score was found to be 0 and the highest score was 22. The initial average BDI score was calculated as 6.80 ± SD 5.64. After the 3-month vitamin D replacement therapy, patients' BDI scores were measured again. According to these measurements, the lowest score remained 0, and the highest score was determined to be 23. The post-treatment average BDI score was calculated as 6.84 ± SD 5.91. No statistically significant change was detected when comparing the baseline and 3-month BDI scores (p = 0.846). These results indicate that there was no significant change in patients' depression levels after vitamin D replacement therapy. Upon examining the initial International Restless Legs Syndrome Study Group (IRLSSG) symptom scale scores of the 25 patients participating in the study, the lowest score was found to be 5 and the highest score was 29. The initial average IRLSSG symptom scale score was calculated as 15.36 ± SD 6.75. After the 3-month vitamin D replacement therapy, patients' IRLSSG symptom scale scores were measured again. According to these measurements, the lowest score was 5 and the highest score remained 29. The post-treatment average IRLSSG symptom scale score was calculated as 14.28 ± SD 6.22. The IRLSSG symptom scale scores after replacement therapy were significantly lower compared to baseline (p = 0.019). Upon examining the initial Pittsburgh Sleep Quality Index (PSQI) scores of the 25 patients participating in the study, the lowest score was found to be 9 and the highest score was 17. The initial average PSQI score was 11.76 ± SD 1.98. After the vitamin D replacement therapy, patients' PSQI scores were determined to have a minimum value of 7 and a maximum value of 17. The post-treatment average PSQI score was 11.52 ± SD 2.30. There was no statistically significant difference between the baseline and 3-month PSQI scores (p = 0.242). When analyzing the initial Fatigue Severity Scale (FSS) scores of the 25 patients participating in the study, the lowest score was measured to be 1 and the highest score was 55. The initial average FSS score was calculated as 19.32 ± SD 12.34. After the 3-month vitamin D replacement therapy, patients' FSS scores were re-evaluated. According to these measurements, the lowest score was 1, and the highest score remained 55. The post-treatment average FSS score was determined as 18.24 ± SD 11.32. When comparing the baseline and 3-month FSS scores, the 3-month FSS scores were slightly decreased compared to baseline. Although statistical significance was not achieved, p = 0.058 indicated a decrease close to significance. Conclusion: Vitamin D replacement therapy has been shown to have a positive effect on the severity of RLS symptoms, while it did not have a significant effect on sleep quality and depression. A limited effect on fatigue levels was observed. Vitamin D levels in idiopathic RLS patients seem to be associated with the severity of disease symptoms. Monitoring vitamin D levels in RLS patients and administering replacement therapy in those with deficiencies may suggest a reduction in the severity of disease symptoms. Keywords: Restless Legs Syndrome, Vitamin D, Depression, Fatigue, Sleep Quality.
Açıklama
Anahtar Kelimeler
Nöroloji, Neurology
