Polinöropatinin Tip 2 Diabetes Mellituslu Hastaların Alt Ekstremite Kas Gücü, Yürüme Performansı ve Günlük Yaşam Aktiviteleri Üzerinde Etkileri Var Mıdır? Prospektif Kontrollü Bir Çalışma

Year 2022, , 14 - 21, 28.04.2022

Gülseren Dost Sürücü , Ayşe Atılgan Çelik , Adem Yıldırım , Dilay Eken Gedik

https://doi.org/10.35440/hutfd.949013

Abstract

Amaç:Bu çalışmanın amacı ; polinöropatisi(PNP) olan ve olmayan Tip 2 Diyabetes Mellitus(DM) hastalarının alt ekstremite kas güçlerinin izokinetik yöntemlerle değerlendirilmesi ve hastalardaki olası kas gücü kayıplarının, hastaların günlük yaşamlarını ve yaşam kalitelerini ne düzeyde etkilediğini sağlıklı kontrollerle karşılaştırarak saptamaktı. Araç ve Yöntemler: Bu prospektif kontrollü çalışmamıza , 40-70 yaş arası 60 Tip 2 DM’li ve 30 sağlıklı birey dahil edilmiştir. Tip 2 DM’li 60 hastadan PNP’si olan 30 hasta Grup 1’i, PNP’si olmayan 30 hasta ise Grup 2’yi oluşturacak şekilde gruplandırıldı.Tüm katılımcılara yaşam kalitesini değerlendirmek amacıyla Kısa Form-36 (SF 36) kullanıldı. Fonksiyonel değerlendirme için merdiven inip çıkma testi (Stair Climb test=SCT) ve zamanlı kalk yürü testi (The Timed Up & Go=TUG) yapıldı. Ayrıca tüm katılımcıların kas gücü Biodex marka izokinetik cihaz yardımıyla ölçüldü..Bulgular:Çalışmaya alınan Tüm DM’li hastaların kas gücü sağlıklı gruba göre düşük,yaşam kalitesini ölçen SF-36 bütün paremetreleri düşük olarak bulundu. Bu farklılık istatistiksel olarak anlamlıydı(p<0.01).Ayrıca tüm DM’li hastaların TUG ve SCT testlerini sağlıklı gruba göre daha uzun sürede tamamlandığı belirlendi. (p<0.05).Sonuç:Bu çalışmanın sonuçlarına göre, polinöropati varlığından bağımsız olarak DM'nin kas gücünde azalmaya neden olduğu ve bunun da hastaların yaşam kalitesini etkilediğini göstermiştir.
Anahtar kelimeler:Diyabetes Mellitus, Polinöropati, Kas Gücü

Keywords

Diyabetes Mellitus, Polinöropati, Kas Gücü

References

• 1. Emerging Risk Factors Collaboration. Diabetes Mellitus, fasting blood glucose concentration and risk of vascular disease: 102 A joint meta-analysis of prospective study. The Lancet , 2010; 375 (9733): 2215-222
• 2. Orr R, Tsang T, Lam P, Comino E, Singh MT Mobility impairment in type 2 diabetes: association with muscle power and effect of Tai Chi intervention. Diabetes Care 2006; 9(9): 2120-2122.
• 3. Loerbroks A, Herr RM, Icks A, Bosch JA The association of self‐reported diabetes with impaired social functioning in low‐, middle‐and high‐income countries: findings from the World Health Survey. Diabet Med 2018; 35(3): 332-338.
• 4. Rubin RR, Peyrot M Quality of life and diabetes. Diabetes Metab Res Rev 1999; 15(3): 205-218.
• 5. Gregg, E. W., Beckles, G. L., Williamson, D. F., Leveille, S. G., Langlois, J. A., Engelgau, M. M., et al.(2000) Diabetes and physical disability among older US adults. Diabetes Care 2000; 23(9):1272-1277. 6. Volpato S, Blaum C, Resnick H, Ferrucci L, Fried LP Comorbidities and impairments explaining the association between diabetes and lower extremity disability: The Women’s Health and Aging Study. Diabetes Care 2002; 25(4): 678-683.
• 7. IJzerman TH, Schaper NC, Melai T, Meijer K, Willems PJB, Savelberg HHCM Lower extremity muscle strength is reduced in people with type 2 diabetes, with and without polyneuropathy, and is associated with impaired mobility and reduced quality of life. Diabetes Res Clin Pract 2012; 95(3):345-351.
• 8. Andersen H, Nielsen S, Mogensen CE, Jakobsen J Muscle strength in type 2 diabetes. Diabetes 2004; 53(6):1543-1548.
• 9. Van Schie CH Neuropathy: mobility and quality of life. Diabetes Metab Res Rev 2008; 24: 45-51.
• 10. Oberbach, A., Bossenz, Y., Lehmann, S., Niebauer, J., Adams, V., Paschke, R., et al. Altered fiber distribution and fiber-specific glycolytic and oxidative enzyme activity in skeletal mucle of patients with type 2 diabetes. Diabetes Care 2006; 29(4):895-900.
• 11. Womack L, Peters D, Barrett EJ, Kaul S, Price W, Lindner JR (2009) Abnormal skeletal muscle capillary recruitment during exercise in patients with type 2 diabetes mellitus and microvascular complications. J Am Coll Cardiol 2009; 53(23): 2175-2183.
• 12. Vinik AI, Strotmeyer ES, Nakave AA, Patel CV Diabetic neuropathy in older adults. Clin Geriatr Med 2008; 24(3):407-435.
• 13. Van Acker, K., Bouhassira, D., De Bacquer, D., Weiss, S., Matthys, K., Raemen, H., et al. Prevalence and impact on quality of life of peripheral neuropathy with or without neuropathic pain in type 1 and type 2 diabetic patients attending hospital outpatients clinics. Diabetes Metab 2009; 35(3): 206-213.
• 14. Callaghan BC, Cheng HT, Stables CL, Smith AL, Feldman EL Diabetic neuropathy: clinical manifestations and current treatments. Lancet Neurol 2012; 11(6): 521-534.
• 15. Andreassen CS, Jakobsen J, Andersen H Muscle weakness: a progressive late complication in diabetic distal symmetric polyneuropathy. Diabetes 2006; 55(3): 806-812.
• 16. Andersen H, Poulsen PL, Mogensen CE, Jakobsen J Isokinetic muscle strength in long-term IDDM patients in relation to diabetic complications. Diabetes 1996; 45(4): 440-445.
• 17. McHorney, C. A., Ware Jr, J. E., & Raczek, A. E. The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Medical care, 1993; 247-263.
• 18. Nightingale EJ, Pourkazemi F, Hiller CE. Systematic review of timed stair tests.J Rehabil Res Dev. 2014 ; 51(3): 335-50.
• 19. Pangilinan J, Quanstrom K, Bridge M, Walter LC, Finlayson E, Suskind AM.T he Timed Up and Go Test as a Measure of Frailty in Urologic Practice. Urology. 2017; 106: 32-8
• 20. Mokdad, A. H., Ford, E. S., Bowman, B. A., Nelson, D. E., Engelgau, M. M., Vinicor, F., et al. Diabetes trends in the US: 1990-1998. Diabetes Care 2000; 23(9): 1278-1283.
• 21. Bruce DG, Davis WA, Davis TME Longitudinal predictors of reduced mobility and physical disability in patients with type 2 diabetes: the Fremantle Diabetes Study. Diabetes Care 2005; 28(10):2 441-2447.
• 22. Park Park, S. W., Goodpaster, B. H., Strotmeyer, E. S., de Rekeneire, N., Harris, T. B., Schwartz, A. V., et al. Decreased muscle strength and quality in older adults with type 2 diabetes: the health, aging, and body composition study. Diabetes 2006; 55(6): 1813-1818.
• 23. Andersen H, Stalberg E, Gjerstad MD, Jakobsen J Association of muscle strength and electrophysiological measures of reinnervation in diabetic neuropathy. Muscle Nerve 1998; 21(12): 1647-1654.
• 24. De Rekeneire, N., Resnick, H. E., Schwartz, A. V., Shorr, R. I., Kuller, L. H., Simonsick, E. M., et al. Diabetes is associated with subclinical functional limitation in nondisabled older individuals: the Health, Aging, and Body Composition study. Diabetes Care 2003; 26(12): 3257-3263.
• 25. Cesari, M., Penninx, B. W., Pahor, M., Lauretani, F., Corsi, A. M., Williams, G. R., et al. Inflammatory markers and physical performance in older persons: the InCHIANTI study. J Gerontol A Biol Sci Med Sci 2004; 59(3): 242-248.
• 26. Allen MD, Doherty TJ, Rice CL, Kimpinski K Physiology in Medicine: neuromuscular consequences of diabetic neuropathy. J Appl Physiol 2016; 121(1): 1-6.
• 27. Van Sloten, T. T., Savelberg, H. H., Duimel-Peeters, I. G., Meijer, K., Henry, R. M., Stehouwer, C. D., et al. Peripheral neuropathy, decreased muscle strength and obesity are strongly associated with walking in persons with type 2 diabetes without manifest mobility limitations. Diabetes Res Clin Pract 2011; 91(1): 32-39.
• 28. Lauretani, F., Russo, C. R., Bandinelli, S., Bartali, B., Cavazzini, C., Di Iorio, A., et al. Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol 2003; 95(5): 1851-1860.
• 29. Park SW, Goodpaster BH, Strotmeyer ES, Kuller LH, Broudeau R, Kammerer C, et al. Accelerated loss of skeletal muscle strength in older adults with type 2 diabetes: the health, aging, and body composition study. Diabetes Care 2007; 30(6): 1507-1512.
• 30. Volpato, S., Bianchi, L., Lauretani, F., Lauretani, F., Bandinelli, S., Guralnik, J. M., et al. Role of muscle mass and muscle quality in the association between diabetes and gait speed. Diabetes Care 2012; 35(8): 1672-1679.
• 31. Norris, S. L., McNally, T. K., Zhang, X., Burda, B., Chan, B., Chowdhury, F. M., et al. Published norms underestimate the health-related quality of life among persons with type 2 diabetes. J Clin Epidemiol 2011 64(4): 358-365.
• 32. Benbow SJ, Wallymahmed ME, MacFarlane IA Diabetic peripheral neuropathy and quality of life. QJM 1998; 91(11): 733-737.
• 33. Currie CJ, Poole CD, Woehl A et al. The health-related utility and health-related quality of life of hospital-treated subjects with type 1 or type 2 diabetes with particular reference to differing severity of peripheral neuropathy. Diabetologia 2006; 49(10): 2272-2280.
• 34. Galer BS, Gianas A, Jensen MP Painful diabetic polyneuropathy: epidemiology, pain description, and quality of life. Diabetes Res Clin Pract 2000; 47(2): 123-128.
• 35. Haris AH, Hammoud H, Abdul-Hakieim S, Gad HK, Al-Alfy M Isokinetic muscle strength assessment of lower limbs in diabetic neuropathy. Egypt Rheumatol Rehab 2007; 34(2): 239-249.
• 36. Andersen H, Gjerstad MD, Jakobsen Atrophy of foot muscles: a measure of diabetic neuropathy. Diabetes Care 2004; 27(10): 2382-2385.
• 37. Dolan, N. C., Liu, K., Criqui, M. H., Greenland, P., Guralnik, J. M., Chan, C., et al. Peripheral artery disease, diabetes, and reduced lower extremity functioning. Diabetes Care 2002; 25(1): 113-120.