Research Article
BibTex RIS Cite

Fibromiyalji ve Romatoid Artritte Glisemik Kontrolün İnflamatuar Parametreler ve Vitamin Değerleri Üzerine Etkisinin İncelenmesi

Year 2021, Volume: 43 Issue: 4, 382 - 387, 18.05.2021
https://doi.org/10.20515/otd.844052

Abstract

Bu çalışmanın amacı, romatoid artrit ve fibromiyaljili hastalarda, glisemik kontrolün hem inflamatuar belirteçler hem de vitamin değerleri üzerine etkisini karşılaştırmaktır. Hem tip 2 diyabeti olan hem de romatoid artriti olan toplam 62 hasta, hem tip 2 diyabeti hem de fibromiyaljisi olan 76 hastanın, 25 hidroksi vitamin D, vitamin B12, ferritin, folik asit, eritrosit sedimentasyon hızı, C-reaktif protein, açlık glukoz düzeyi, hemoglobin A1c ve tam kan sayımı değerleri retrospektif olarak değerlendirildi. Romatoid artritli hastalarda, fibromiyalji hastalarına göre eritrosit sedimentasyon hızı (p=0.002), C-reaktif protein, platelet/lenfosit ve nötrofil/lenfosit oranları (p<0.001) belirgin yüksek saptandı. Ancak hemoglobin A1c, açlık kan glukozu, monosit/lenfosit oranı ve vitamin değerleri her 2 grup arasında benzer bulundu. Her 2 grup da, hemoglobin A1c değerinin %7’den fazla veya düşük olmasına göre iki gruba ayrıldı. C-reaktif protein (p=0.037) ve monosit/lenfosit oranları (p=0.050) romatoid artritli hastalardan hemoglobin A1c değeri ≥%7 olan hastalarda belirgin olarak yüksek saptanırken, fibromiyaljili hastalarda hiçbir parametre, hemoglobin A1c değerine göre farklılık göstermedi. Bu çalışma sonucuna göre, fibromiyalji ve romatoid artritte, hemoglobin A1c değerleri benzerdir. Kötü glisemik kontrol fibromiyaljideki inflamatuar belirteçleri etkilemeyip, romatoid artritte inflamasyonu kötüleştirmekle birlikte, her 2 hastalık grubunda da vitamin değerlerini etkiliyor gibi görünmemektedir.

Supporting Institution

yoktur

References

  • 1. Avina-Zubieta JA, Choi HK, Sadatsafavi M, et al. Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies. Arthritis Rheum. 2008; 59:1690–7.
  • 2. Backryd E, Tanum L, Lind AL, et al. Evidence of both systemic inflammation and neuroinflammation in fibromyalgia patients, as assessed by a multiplex protein panel applied to the cerebrospinal fluid and to plasma. J Pain Res 2017;10:515–25.
  • 3. Mastrangelo F., Frydas I, Ronconi G, et al. Low-grade chronic inflammation mediated by mast cells in fibromyalgia: role of IL-37. J Biol Regul Homeost Agents 2018;32(2):195-8.
  • 4. Siemons L, ten Klooster PM. How age and sex affect the erythrocyte sedimentation rate and C-reactive protein in early rheumatoid arthritis. BMC Musculoskelet Disord. 2014;15:368.
  • 5. Kurtul A, Duran M. The correlation between lymphocyte/monocyte ratio and coronary collateral circulation in stable coronary artery disease patients. Biomark Med. 2017;11(1):43–52.
  • 6. Du J, Chen S, Shi J, et al. The association between the lymphocyte-monocyte ratio and disease activity in rheumatoid arthritis. Clinical rheumatology 2017;36(12):2689-95.
  • 7. İlgün E, Akyürek Ö, Kalkan AO, et al. Neutrophil/Lymphocyte ratio and Platelet/Lymphocyte ratio in fibromyalgia. Eur J Gen Med. 2016;13(2):100-4.
  • 8. Karabaş Ç, Sütbeyaz ST, Cebiçci MA. Fibromyalji Hastalarinda Nötrofil/lenfosit Orani, Platelet/lenfosit orani ve Ortalama Trombosit Hacminin Değerlendirilmesi. Journal of Anatolian Medical Research 2018;3(1):1-10.
  • 9. Emre ATA, Düzenli T. Fibromiyalji tanısında inflamatuar bir belirteç: platelet dağılım genişliği. Bozok Tıp Dergisi 2019;9(4)73-7.
  • 10. Donath MY, Shoelson SE. Type 2 diabetes as an inflammatory disease. Nat Rev Immunol. 2011;11:98–107.
  • 11. Sarinnapakorn V, Wanicagool W. Association between hs-CRP and Hba1c in overweight type 2 diabetic female patients. Journal of the Medical Association of Thailand= Chotmaihet thangphaet 2016; 96:54-8.
  • 12. Jabeen F, Fawwad A, Rizvi HA, et al. Role of platelet indices, glycemic control and hs-CRP in pathogenesis of vascular complications in type-2 diabetic patients. Pakistan journal of medical sciences 2013;29(1):152.
  • 13. Vasquez A. Neuroinflammation in fibromyalgia and CRPS is multifactorial. Nat Rev Rheumatol 2016;12:242.
  • 14. Goebel A, Buhner S, Schedel R, et al. Altered intestinal permeability in patients with primary fibromyalgia and in patients with complex regional pain syndrome. Rheumatology 2008;47:1223–7.
  • 15. Wolfe F, Smythe HA, Yunus MB, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology 1990;33(2):160-72. 16. American Diabetes Association. Standards of medical care in diabetes-2015. Diabetes Care 2015; 38:1-93.
  • 17. Dessein PH, Joffe BI, Singh S. Biomarkers of endothelial dysfunction, cardiovascular risk factors and atherosclerosis in rheumatoid arthritis. Arthritis Res Ther. 2005; 7:634-43.
  • 18. Tishler M, Smorodin T, Vazina-Amit M, et al. Fibromyalgia in diabetes mellitus. Rheumatology international 2003; 23(4):171-3.
  • 19. Burt MG, Roberts GW, Aguilar-Loza NR, et al. Continuous monitoring of circadian glycemic patterns in patients receiving prednisolone for COPD. J Clin Endocrinol Metab. 2011; 96: 1789-96.
  • 20. Pradhan AD, Manson JE, Rifai N, et al. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA 2001; 286:327–34.
  • 21. Miwa Y, Mitamura Y. Effects of biologic drugs on the prognosis of rheumatoid arthritis among patients with poor diabetes control. European Journal of Rheumatology 2020; 7(2): 60-3.
  • 22. Özcan DS, Öken Ö, Aras M, et al. Fibromiyaljili kadın hastalarda vitamin D düzeyleri ve ağrı, depresyon, uyku ile ilişkisi. Türk Fiz Tıp Rehab Derg. 2014;60:329-34.
  • 23. Kerr GS, Sabahi I, Richards JS, et al. Prevalence of vitamin D insufficiency/deficiency in rheumatoid arthritis and associations with disease severity and activity. The Journal of rheumatology 2011; 38(1):53-9.
  • 24. Uçkun AÇ, Yurdakul FG, Kılıçarslan A, et al. Impact of vitamin D on rheumatoid arthritis: real or just patient’s perception? Archives of Clinical and Experimental Medicine 2018;3(3):127-31.
  • 25. Yılmaz BS, Atalay BG. Obez çocuklarda D vitamini düzeyleri: İnsülin düzeyi ve dislipidemi ile ilişkisinin değerlendirilmesi. Osmangazi Tıp Dergisi 2020;42(6):620-6.
  • 26. Ford ES, Zhao G, Tsai J, Li, C. Associations between concentrations of vitamin D and concentrations of insulin, glucose, and HbA1c among adolescents in the United States. Diabetes Care 2011;34(3):646-8.
  • 27. Karatoprak K, Uysal S, Akkılık ZS, et al. Diyabette glisemik kontrolün serum biyokimyasal parametreleri ile ilişkisi. Abant Med J. 2012; 1(2):51-4.

The Effect of Glycemic Control on İnflammatory Parameters and Vitamin Levels in Patients with Rheumatoid Arthritis and Fibromyalgia

Year 2021, Volume: 43 Issue: 4, 382 - 387, 18.05.2021
https://doi.org/10.20515/otd.844052

Abstract

The aim of this study is to compare the effect of glycemic control on both inflammatory parameters and vitamin levels in both rheumatoid arthritis and fibromyalgia. A total of 76 patients with type 2 diabetes mellitus and rheumatoid arthritis and 76 patients with type 2 diabetes mellitus and fibromyalgia were retrospectively evaluated in terms of the levels of 25 hidroxy vitamin D, vitamin B12, ferritin, folic asit, erythrocyte sedimentation rate, C-reactive protein, fasting blood glucose, hemoglobin A1c and complete blood count. C-reactive protein, ratios of platelet to lymhocyte and neutrophil to lymhocyte (p<0.001) and erythrocyte sedimentation rate (p=0.002) were significantly higher in patients with rheumatoid arthritis. However hemoglobin A1c, fasting glucose level, monocyte to lymhocyte ratio and vitamin levels were similar between patients with rheumatoid arthritis and fibromyalgia. Both groups were divided into two groups according to hemoglobin A1c being higher or lower than 7%. C-reactive protein (p=0.037) and monocyte to lymhocyte ratio (p=0.050) were significantly higher in rheumatoid arthritis patients with hemoglobin A1c≥7% than hemoglobin A1c<7%. However no significant difference was found in any parameter in fibromyalgia patients according to the level of hemoglobin A1c. Our study results showed that the levels of hemoglobin A1c was similar in patients with rheumatoid arthritis and fibromyalgia. And poor glycemic control accelerates inflammation in only rheumatoid arthritis, however it does not seem to effect vitamin levels.

References

  • 1. Avina-Zubieta JA, Choi HK, Sadatsafavi M, et al. Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies. Arthritis Rheum. 2008; 59:1690–7.
  • 2. Backryd E, Tanum L, Lind AL, et al. Evidence of both systemic inflammation and neuroinflammation in fibromyalgia patients, as assessed by a multiplex protein panel applied to the cerebrospinal fluid and to plasma. J Pain Res 2017;10:515–25.
  • 3. Mastrangelo F., Frydas I, Ronconi G, et al. Low-grade chronic inflammation mediated by mast cells in fibromyalgia: role of IL-37. J Biol Regul Homeost Agents 2018;32(2):195-8.
  • 4. Siemons L, ten Klooster PM. How age and sex affect the erythrocyte sedimentation rate and C-reactive protein in early rheumatoid arthritis. BMC Musculoskelet Disord. 2014;15:368.
  • 5. Kurtul A, Duran M. The correlation between lymphocyte/monocyte ratio and coronary collateral circulation in stable coronary artery disease patients. Biomark Med. 2017;11(1):43–52.
  • 6. Du J, Chen S, Shi J, et al. The association between the lymphocyte-monocyte ratio and disease activity in rheumatoid arthritis. Clinical rheumatology 2017;36(12):2689-95.
  • 7. İlgün E, Akyürek Ö, Kalkan AO, et al. Neutrophil/Lymphocyte ratio and Platelet/Lymphocyte ratio in fibromyalgia. Eur J Gen Med. 2016;13(2):100-4.
  • 8. Karabaş Ç, Sütbeyaz ST, Cebiçci MA. Fibromyalji Hastalarinda Nötrofil/lenfosit Orani, Platelet/lenfosit orani ve Ortalama Trombosit Hacminin Değerlendirilmesi. Journal of Anatolian Medical Research 2018;3(1):1-10.
  • 9. Emre ATA, Düzenli T. Fibromiyalji tanısında inflamatuar bir belirteç: platelet dağılım genişliği. Bozok Tıp Dergisi 2019;9(4)73-7.
  • 10. Donath MY, Shoelson SE. Type 2 diabetes as an inflammatory disease. Nat Rev Immunol. 2011;11:98–107.
  • 11. Sarinnapakorn V, Wanicagool W. Association between hs-CRP and Hba1c in overweight type 2 diabetic female patients. Journal of the Medical Association of Thailand= Chotmaihet thangphaet 2016; 96:54-8.
  • 12. Jabeen F, Fawwad A, Rizvi HA, et al. Role of platelet indices, glycemic control and hs-CRP in pathogenesis of vascular complications in type-2 diabetic patients. Pakistan journal of medical sciences 2013;29(1):152.
  • 13. Vasquez A. Neuroinflammation in fibromyalgia and CRPS is multifactorial. Nat Rev Rheumatol 2016;12:242.
  • 14. Goebel A, Buhner S, Schedel R, et al. Altered intestinal permeability in patients with primary fibromyalgia and in patients with complex regional pain syndrome. Rheumatology 2008;47:1223–7.
  • 15. Wolfe F, Smythe HA, Yunus MB, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology 1990;33(2):160-72. 16. American Diabetes Association. Standards of medical care in diabetes-2015. Diabetes Care 2015; 38:1-93.
  • 17. Dessein PH, Joffe BI, Singh S. Biomarkers of endothelial dysfunction, cardiovascular risk factors and atherosclerosis in rheumatoid arthritis. Arthritis Res Ther. 2005; 7:634-43.
  • 18. Tishler M, Smorodin T, Vazina-Amit M, et al. Fibromyalgia in diabetes mellitus. Rheumatology international 2003; 23(4):171-3.
  • 19. Burt MG, Roberts GW, Aguilar-Loza NR, et al. Continuous monitoring of circadian glycemic patterns in patients receiving prednisolone for COPD. J Clin Endocrinol Metab. 2011; 96: 1789-96.
  • 20. Pradhan AD, Manson JE, Rifai N, et al. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA 2001; 286:327–34.
  • 21. Miwa Y, Mitamura Y. Effects of biologic drugs on the prognosis of rheumatoid arthritis among patients with poor diabetes control. European Journal of Rheumatology 2020; 7(2): 60-3.
  • 22. Özcan DS, Öken Ö, Aras M, et al. Fibromiyaljili kadın hastalarda vitamin D düzeyleri ve ağrı, depresyon, uyku ile ilişkisi. Türk Fiz Tıp Rehab Derg. 2014;60:329-34.
  • 23. Kerr GS, Sabahi I, Richards JS, et al. Prevalence of vitamin D insufficiency/deficiency in rheumatoid arthritis and associations with disease severity and activity. The Journal of rheumatology 2011; 38(1):53-9.
  • 24. Uçkun AÇ, Yurdakul FG, Kılıçarslan A, et al. Impact of vitamin D on rheumatoid arthritis: real or just patient’s perception? Archives of Clinical and Experimental Medicine 2018;3(3):127-31.
  • 25. Yılmaz BS, Atalay BG. Obez çocuklarda D vitamini düzeyleri: İnsülin düzeyi ve dislipidemi ile ilişkisinin değerlendirilmesi. Osmangazi Tıp Dergisi 2020;42(6):620-6.
  • 26. Ford ES, Zhao G, Tsai J, Li, C. Associations between concentrations of vitamin D and concentrations of insulin, glucose, and HbA1c among adolescents in the United States. Diabetes Care 2011;34(3):646-8.
  • 27. Karatoprak K, Uysal S, Akkılık ZS, et al. Diyabette glisemik kontrolün serum biyokimyasal parametreleri ile ilişkisi. Abant Med J. 2012; 1(2):51-4.
There are 26 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section ORİJİNAL MAKALE
Authors

Fulya Bakılan 0000-0003-2943-4833

Anıl Uçan This is me 0000-0001-8771-6121

Burcu Ortanca 0000-0001-5421-0116

Publication Date May 18, 2021
Published in Issue Year 2021 Volume: 43 Issue: 4

Cite

Vancouver Bakılan F, Uçan A, Ortanca B. The Effect of Glycemic Control on İnflammatory Parameters and Vitamin Levels in Patients with Rheumatoid Arthritis and Fibromyalgia. Osmangazi Tıp Dergisi. 2021;43(4):382-7.


13299        13308       13306       13305    13307  1330126978