OSTEOARTRİTLİ HASTALARDA METABOLİK SENDROM SIKLIĞI VE ETKİLEYEN FAKTÖRLER

Year 2021, , 105 - 116, 25.03.2021

Sibel Şentürk , Dilek Efe Arslan , Murat Korkmaz

https://doi.org/10.33715/inonusaglik.812103

Abstract

Bu araştırmanın amacı, osteoartritli (OA) hastalarda metabolik sendrom (MetS) görülme sıklığını ve bu durumu etkileyen faktörleri belirlemektir. Tanımlayıcı, retrospektif ve kesitsel olan bu çalışma, Eylül 2018-Mart 2019 tarihleri arasında 95 OA ile tamamlandı. Araştırmaya 38 yaş ve üzeri, Amerikan Radyoloji Koleji kriterlerine göre hekim tarafından OA tanısı konmuş ve en az 1 yıldır OA rahatsızlığı olan hastalar dâhil edildi. MetS tanısını koyabilmek amacıyla Amerikan Kalp Birliği Ulusal Kolesterol Eğitim Programının oluşturduğu Erişkin Tedavi Paneli-III tanı kriterleri kullanıldı. Verilerin istatistiksel değerlendirilmesinde sayı, yüzde, ortalama değerleri ile ki-kare testi kullanıldı. OA’lı bireylerin yaş ortalaması 66,94±7,29 olup, %76,8’i kadındı. OA’lı bireylerin hastalık süresi ortalaması 10,06±6,79 yıl, beden kütle indeksi (BKI) ortalaması 32,97±5,07, total kolesterol düzeyi ortalaması 187,36±75,75, yüksek yoğunluklu lipoprotein (HDL) ortalaması 50,36±6,29, düşük yoğunluklu lipoprotein (LDL) ortalaması 131,93±25,73 ve açlık kan şekeri (AKŞ) ortalaması 132,04±68,81 idi. Erişkin Tedavi Paneli ölçütlerine göre bireylerin %83,2’sinin MetS’e neden olan üç ve üçten fazla bileşen taşıdığı saptandı. OA’lı bireylerin MetS durumlarının sosyo-demografik verilerle karşılaştırılmasında, MetS varlığının kronik hastalık durumu (p:0,027) ve antihipertansif ilaç kullanma durumu (p:0,000) ile aralarındaki fark istatistiksel olarak anlamlı bulundu. Bu araştırmada, OA’lı bireyler arasında MetS görülme sıklığı yüksek düzeyde bulunmuştur. MetS ile birlikte farklı hastalıkların görülmesi, bu hastaların multidisipliner bir yaklaşımla tedavi ve bakıma alınması gerekliliğini ortaya koymaktadır.

Keywords

Osteoartrit, Metabolik Sendrom, Sıklık, Etkileyen Faktörler

Frequency of metabolic syndrome in patients with osteoarthritis and affecting factors

Abstract

The aim of this study is to determine the prevalence of metabolic syndrome (MetS) in patients with osteoarthritis (OA) and the factors affecting this condition. This descriptive, retrospective, and cross-sectional study was completed with 95 OA between September 2018 and March 2019. Patients over the age of 38, who had been diagnosed with OA according to the American College of Radiology criteria and had OA at least for one year, were included in the study. In order to diagnose MetS, the Adult Treatment Panel-III diagnostic criteria established by the American Heart Association National Cholesterol Education Program were used. Number, percentage, average values and chi-square test were used for statistical analysis of the data. The mean age of the patients with OA was 66.9±7.29, and 76.8% of them were female. Of the OA patients; mean of the duration of the disease was 10.06±6.79 years, mean of the body mass index (BMI) was 32.97±5.07, mean of the total cholesterol level was 187.36±75.75, mean of the high density lipoprotein (HDL) was 50.36±6.29, mean of the low density lipoprotein (LDL) was 131.93±25.73, and mean of the fasting blood sugar (FBS) was 132.04±68.81. According to the Adult Treatment Panel criteria, 83.2% of the individuals were found to have three or more than three components that cause MetS. In the comparison of the MetS status of individuals with OA with socio-demographic data, the difference between the presence of MetS and chronic disease status (p: 0.027) and antihypertensive drug use (p: 0.000) was found to be statistically significant. In this study, the incidence of MetS has been found to be high among patients with OA. The occurrence of different diseases along with MetS reveals that these patients need a multidisciplinary approach for the treatment and care.

Keywords

Osteoarthritis, Metabolic Syndrome, Frequency, Affecting Factors

References

• Abourazzak, F. E., Talbi, S., Lazrak, F., Azzouzi, H., Aradoini, N., Keita, S.,… Harzy, T. (2015). Does metabolic syndrome or its individual components affect pain and function in knee osteoarthritis women? Current Rheumatology Reviews, 11, 8-14.
• Afifi, A. M. A., Shaat, R. M., Gharbia, O. M., Boghdadi, Y. E., Eshmawy, M. E., El-Emam, O. A. (2018). Osteoarthritis of knee joint in metabolic syndrome. Clinical Rheumatology, 37, 2855-2861.
• Ajubi, N. E., Klein-Nulend, J., Nijweide, P. J., Vrijheid-Lammers, T., Alblas, M. J., Burger, E. H. (1996). Pulsating fluid flow increases prostaglandin production by cultured chicken osteocytesa cytoskeletondependent process. Biochem Biophys Res Commun, 225, 62-68.
• Blagojevic, M., Jinks, C., Jeffery, A., Jordan, K. P. (2010). Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis. Osteoarthritis and Cartilage, 18, 24-33.
• Conaghan, P. G., Vanharanta, H., Dieppe, P. A. I. (2005). Progressive osteoarthritis anatheromatous vascular disease?, Annals of the Rheumatic Diseases, 64(11), 1539-41.
• DeGroot, J. (2004). The AGE of the matrix: chemistry, consequence and cure. Curr Opin Pharmaco, 4, 301-305.
• Dicesare, P. E., Abramson, S. B (2005). Pathogenesis of osteoarthritis. Harris, E. D., Budd, R. C., Genovese, M. C., et al (Eds). Kelley's textbook of rheumatology. Elsevier Saunders, Philadelphia, 2, 1493-1513.
• Dünya Sağlık Örgütü (DSÖ). Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO Consultation. World Health Organization, 1999. 24 Eylül 2020 tarihinde https://apps.who.int/iris/bitstream/handle/10665/66040/WHO_NCD_NCS_99.2.pdf;jsessionid=72195BF7147CFF0371E1C580B9CD4EFB?sequence=1 adresinden erişildi.
• Eckel, R. H., Grundy, S. M., Zimmet, P. Z. (2005). The metabolic syndrome. The Lancet, 365(9468), 1415-1428.
• Egloff, C., Hügle, T., Valderrabano, V. (2012). Biomechanics and pathomechanisms of osteoarthritis. Swiss Medical Weekly, 142, 1-14.
• Ekecik, A., Akdeniz, Ö., Akyürek, A. B. (2009). 65 yaş ve üzerindeki geriatrik hastalarda metabolik sendrom sıklığı. Sağlık Bilimleri Dergisi, 18(3), 154-158.
• Gökoğlu, F., Gürsoy, H., Borman, P., Özyılkan, E., Yorgancıoğlu, Z. R. (2008). Osteoartrit olan hastalardaki metabolik sendrom. Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi, 2, 46-52.
• Hakim, A. J., Clunie, G. P. R., Hag, I. (2009). Osteoartrit. Özer, H. T. E., Güzel, R. (Eds). Romatoloji el kitabı. Nobel Tıp Kitabevleri, Ankara, 259-267.
• Kroop, S. F., Simon, L. S. (1994). Joint and bone manifastations of diabetes mellitus. Kahn, C. R., Weir, G. C. (Eds). Joslin’s diabetes mellitus. Lee & Febiger, Philadelphia, 912- 920.
• Lee, B. J., Yang, S., Kwon, S., Choi, K. H., Kim, W. (2019). Association between metabolic syndrome and knee osteoarthritis: A cross-sectional nationwide survey study. Journal of Rehabilitation Medicine, 51, 464–470.
• Ling, S. M., Rudolph, K. (2007). Osteoartrit. Dinç, A. (Ed). Romatizmal hastalıklarda klinik tedavi. RAED Yayınları, Ankara, 127-134.
• Mahajan, A., Verma, S., Tandon, V. (2005). Osteoarthritis. Journal of the Association of Physicians of India, 53, 634-641.
• Massicotte, F. (2011). Epidemiology of osteoarthritis. Martel-Pelletier J., Pelletier J. P. (Eds). Understanding osteoarthritis from bench to bedside. Research Signpost, India, 1-26.
• Morovic-Vergles, J., Salamon, L., Marasovic-Krstulovic, D., Kehler, T., Sakić, D., Badovinac, O.,… Gamulin, S. (2013). Is the prevalence of arterial hypertension in rheumatoid arthritis and osteoarthritis associated with disease? Rheumatology International, 33(5), 1185e1192.
• Murphy, L., Schwartz, T. A., Helmick, C. G., Renner, J. B., Tudor, G., Koch, G.,… Jordan, J. M. (2008). Lifetime risk of symptomatic knee osteoarthritis. Arthritis & Rheumatism, 59, 1207-1213.
• National Cholesterol Education Program (NCEP). Expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III). National Heart, Lung and Blood Institute: NIH Publication 2001. 24 Eylül 2020 tarihinde https://www.nhlbi.nih.gov/files/docs/resources/heart/atp-3-cholesterol-full-report.pdf adresinden erişildi.
• Niu, J., Clancy, M., Aliabadi, P., Vasan, R., Felson, D. T. (2017). Metabolic syndrome, its components, and knee osteoarthritis. Arthritis & Rheumatism, 69(6), 1194-1203.
• Niu, J., Zhang, Y. Q., Torner, J., Nevitt, M., Lewis, C. E., Aliabadi, P.,…Felson, D. T. (2009). Is obesity a risk factor for progressive radiographic knee osteoarthritis? Arthritis & Rheumatism, 61, 329-335.
• Pottie, P., Presle, N., Terlain, B., Netter, P., Mainard, D., Berenbaum, F. (2006). Obesity and osteoarthritis: more complex than predicted! Ann Rheum Dis, 65, 1403–1405.
• Puenpatom, R. A., Victor, T. W. (2009). Increased prevalence of metabolic syndrome inindividuals with osteoarthritis: An analysis of NHANES III data. Postgraduate Medicine, 121(6), 9-20.
• Rejeski, W. J., Focht, B. C., Messier, S. P., Morgan, T., Pahor, M., Penninx, B. (2002). Obese, older adults with knee osteoarthritis: Weight loss, exercise and quality of life. Health Psychology, 21, 419-426.
• Schett, G., Kleyer, A., Perricone, C., Sahinbegovic, E., Iagnocco, A., Zwerina, J.,…Kiechl, S. (2013). Diabetes is an independent predictor for severe osteoarthritis: Results from a longitudinal cohort study. Diabetes Care, 36(2), 403-409.
• Sezer Balcı, A., Kolaç, N., Yıldız, E., Kara, S., Çetin, M., Erdoğan, E. (2018).Ofis çalışanlarında metabolik sendrom. Turkish Journal of Cardiovascular Nursing, 9(19), 50-57.
• Shin, D. (2014). Association between metabolic syndrome, radiographic knee osteoarthritis and intensity of knee pain: Results of a national survey. The Journal of Clinical Endocrinology & Metabolism, 99(9), 3177-3183.
• Swift, A. (2012). Osteoarthritis 1: Physiology, risk factors and causes of pain. Nursing Times, 108, 12-15.
• Vohra, I., Singh, A., Ali, S., Verma, N. S., Kumar, A., Katiyar, V. (2015). Correlation of hypertension with the severity of osteoarthritis of knee. International Journal of Biomedical Research, 6(4), 238-241.
• Vos, T., Flaxman, A. D., Naghavi, M., Lozano, R., Michaud, C., Ezzati, M.,…Murray, C. J. L. (2012). Years lived with disability (YLDs) for1160 sequelae of 289 diseases and injuries 1990-2010: A systematic analysis for the global burden of disease study 2010. The Lancet, 380(9859), 2163-2196.
• Wang, H., Cheng, Y., Shao, D., Chen, J., Sang, Y., Gui, T.,…Zha, Z. (2016). Metabolic syndrome increases the risk for knee osteoarthritis: A meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2016, 1-7.
• Xie, D-x., Wei, J., Zeng, C., Yang, T., Li, H., Wang, Y-l.,…Lei, G-h. (2017). Association between metabolic syndrome and knee osteoarthritis: A cross-sectional study. BMC Musculoskeletal Disorders, 18, 533.
• Yoshimura, N., Muraki, S., Oka, H., Tanaka, S., Kawaguchi, H., Nakamura, K., …Akune, T. (2012). Accumulation of metabolic risk factors such as overweight, hypertension, dyslipidaemia, and impaired glucose tolerance raises the risk of occurrence and progression of knee osteoarthritis: A 3-year follow-up of the ROAD study. Osteoarthritis and Cartilage, 20(11), 1217-1226.
• Zhang, Y., Wang, J., Liu, X. (2017).Association between hypertension and risk of knee osteoarthritis. A meta-analysis of observational studies. Medicine, 96(32), e7584.
• Zhuo, Q., Yang, W., Chen, J., Wang, Y. (2012). Metabolic syndrome meets osteoarthritis. Nature Reviews Rheumatology, 8(12), 729-37.