Ankilozan spondilit hastalarında sarkopeni sıklığı ve ilişkili olabilecek faktörler
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Dosyalar
Tarih
2020
Yazarlar
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Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Ankilozan spondilit (AS) hastaları, kronik inflamatuvar süreçler ve disabilite ilişkili fiziksel inaktivite nedeniyle sarkopeni açısından risk altındadır. Buna rağmen AS hastalarında sarkopeni prevelansı ve ilişkili faktörlerin araştırıldığı çalışma sayısı az, sonuçları da çelişkilidir. Bu çalışmada AS hastalarında sarkopeni sıklığı ve ilişkili faktörlerin belirlenmesi amaçlanmıştır. Gereç ve yöntem: Modifiye New York kriterlerine göre tanı almış, 18-68 yaş aralığında, 102 AS hastasının dahil edildiği kesitsel bir çalışma yürütüldü. Olguların kas gücü, manuel el dinamometresi ile ölçüldü, kadınlarda 16 kg, erkeklerde 27 kg altındaki değerler anormal kabul edildi. Hastaların kas kütleleri biyoelektrik empedans analizi (BIA) ile değerlendirildi ve iskelet kası indeksi (SMI) (kg/m²) olarak belirtildi. SMI değeri için, yaşlılarda Sarkopeni ile ilgili Avrupa Çalışma Grubu (EWGSOP) tarafından önerilen, kadınlarda 8.87 kg/m², erkeklerde 6.42 kg/m² kesim noktaları kulllanıldı. Hastalar bu sonuçlara göre sadece kas güçsüzlüğü olanlar 'muhtemel sarkopeni grubu', kas güçsüzlüğü ve kas kütlesinde azalma saptanan hastalar 'sarkopenik grup' ve her iki parametrenin de normal olduğu 'sarkopenik olmayan grup' olmak üzere 3 gruba ayrıldı ve ilişkili faktörler incelendi. Bulgular: Sarkopenik hastalarda yaş ortalaması anlamlı derecede yüksekti (p<0,01). Beden kitle indeksi (BMI) ortalaması sarkopenik grupta daha düşüktü ancak aradaki fark istatistiksel olarak anlamlı değildi (p=0,061, p>0,05). HLA-B27 pozitifliği, eritrosit sedimentasyon hızı (ESH), C reaktif protein (CRP) düzeyleri açısından gruplar arasında anlamlı fark saptanmazken hemoglobin düzeyleri sarkopenik grupta anlamlı derecede düşüktü (p<0,05). Hastalık süresi, sarkopeni ve muhtemel sarkopeni grubunda anlamlı derecede yüksek saptandı. Bath Ankilozan Spondilit Fonksiyonel İndeksi (BASFI), Bath Ankilozan Spondilit Metroloji İndeksi (BASMI), sağlık değerlendirme anketi (HAQ) skorları sarkopenik ve muhtemel sarkopenik grupta anlamlı düzeyde yüksekti (<0,001). Bath Ankilozan Spondilit Hastalık Aktivite İndeksi (BASDAİ) ve visüel analog skala (VAS) skorları, muhtemel sarkopeni grubunda diğer gruplara göre anlamlı derecede yüksekti. Sarkopeni grubunda BASDAİ ve VAS skorları, sarkopenik olmayan gruba göre yüksek olmasına rağmen aradaki fark anlamlı değildi. Fiziksel aktivite seviyeleri sarkopenik grupta anlamlı düzeyde düşüktü (p<0,001). Sonuç: AS hastalarında %7,8 oranında sarkopeni, %12,67 oranında da ileride sarkopeni gelişimi açısından takip edilmesi gereken muhtemel sarkopeni hastası saptandı. İleri yaş, uzun hastalık süresi, fonksiyonelliği kısıtlayan aktif hastalık, düşük fiziksel aktivite düzeyi AS hastalarında sarkopeni gelişimi ile ilişkili bulundu.
Aim: AS patients are at risk for sarcopenia due to chronic inflammatory processes and physical inactivity associated with disability. Despite this, studies investigating the prevalence of sarcopenia and associated factors in patients with AS is still lacking, and the results are also contradictory. The aim of this study was to evaluate the prevalence and risk factors of sarcopenia in patients with ankylosing spondylitis. Materials and methods: A cross-sectional study was conducted involving 102 AS patients, aged 18-68, who were diagnosed according to Modified New York criteria. Muscle strength of the cases was measured with a manual hand dynamometer, values below 16 kg in women and 27 kg in men were considered abnormal. The muscle mass of the patients was evaluated by bioelectric impedance analysis (BIA) and indicated as skeletal musle mass index (SMI) (kg/m2). For the SMI value, 8.87 kg/m2 in women and 6.42 kg/m2 in men were used as recommended by the European Working Group on Sarcopenia in Older People (EWGSOP). According to these results, patients were divided into 3 groups (sarcopenic, probable sarcopenic, nonsarcopenic) and associated factors were examined. Findings: Mean age was significantly higher in sarcopenic patients (p<0.01). The mean body mass index (BMI) was lower in the sarcopenic group, but the difference was not statistically significant (p=0.061, p>0.05). No significant differences were found between the groups in terms of HLA-B27 positivity, erythrocyte sedimentation rate (ESH), C reactive protein (CRP) levels, while hemoglobin levels were significantly lower in the sarcopenic group (p<0.05). The duration of the disease was significantly higher in the group of sarcopenia and probable sarcopenia. Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), health assessment questionnaire (HAQ) scores were significantly higher in the sarcopenic and probable sarcopenic group (<0,001). Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and visual analog scale (VAS) scores were significantly higher in the probable sarcopenia group than in other groups. Although BASDAI and VAS scores were high in the sarcopenic group compared to the non-sarcopenic group, the difference was not significant. Physical activity levels were significantly lower in the sarcopenic group (p<0.001). Conclusion: 7.8% sarcopenia and 12.67% probable sarcopenia patients who should be monitored for the development of sarcopenia in the future, were identified in AS patients. Advanced age, long duration of illness, active disease that restricts functionality, and low levels of physical activity were associated with the development of sarcopenia in AS patients.
Aim: AS patients are at risk for sarcopenia due to chronic inflammatory processes and physical inactivity associated with disability. Despite this, studies investigating the prevalence of sarcopenia and associated factors in patients with AS is still lacking, and the results are also contradictory. The aim of this study was to evaluate the prevalence and risk factors of sarcopenia in patients with ankylosing spondylitis. Materials and methods: A cross-sectional study was conducted involving 102 AS patients, aged 18-68, who were diagnosed according to Modified New York criteria. Muscle strength of the cases was measured with a manual hand dynamometer, values below 16 kg in women and 27 kg in men were considered abnormal. The muscle mass of the patients was evaluated by bioelectric impedance analysis (BIA) and indicated as skeletal musle mass index (SMI) (kg/m2). For the SMI value, 8.87 kg/m2 in women and 6.42 kg/m2 in men were used as recommended by the European Working Group on Sarcopenia in Older People (EWGSOP). According to these results, patients were divided into 3 groups (sarcopenic, probable sarcopenic, nonsarcopenic) and associated factors were examined. Findings: Mean age was significantly higher in sarcopenic patients (p<0.01). The mean body mass index (BMI) was lower in the sarcopenic group, but the difference was not statistically significant (p=0.061, p>0.05). No significant differences were found between the groups in terms of HLA-B27 positivity, erythrocyte sedimentation rate (ESH), C reactive protein (CRP) levels, while hemoglobin levels were significantly lower in the sarcopenic group (p<0.05). The duration of the disease was significantly higher in the group of sarcopenia and probable sarcopenia. Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), health assessment questionnaire (HAQ) scores were significantly higher in the sarcopenic and probable sarcopenic group (<0,001). Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and visual analog scale (VAS) scores were significantly higher in the probable sarcopenia group than in other groups. Although BASDAI and VAS scores were high in the sarcopenic group compared to the non-sarcopenic group, the difference was not significant. Physical activity levels were significantly lower in the sarcopenic group (p<0.001). Conclusion: 7.8% sarcopenia and 12.67% probable sarcopenia patients who should be monitored for the development of sarcopenia in the future, were identified in AS patients. Advanced age, long duration of illness, active disease that restricts functionality, and low levels of physical activity were associated with the development of sarcopenia in AS patients.
Açıklama
YÖK Tez No: 653261
Anahtar Kelimeler
Fiziksel Tıp ve Rehabilitasyon, Physical Medicine and Rehabilitation, Sarkopeni, Ankilozan spondilit, hastalık aktivitesi, fiziksel aktivite, sarcopenia, Ankylosing Spondylitis, disease activity, physical activity
