Tip 2 Diyabetli Yaşlı Hastalarda El Kavrama Gücü ile Hematolojik Belirteçler Arasındaki İlişki

Yıl 2025, Cilt: 22 Sayı: 4

Mehmet Göl , İbrahim Halil Türkbeyler , Güzin Çakmak , Ayşe Fulya Özkanlı , Ayse Elkoca , Sedat Özdemir

Öz

Amaç: Bu çalışmada, tip 2 diabetes mellitus (T2DM) tanılı yaşlı bireylerde inflamatuvar ve hematolojik parametreler ile el sıkma gücü (ESG) arasındaki ilişkiyi değerlendirmek amaçlandı.
Materyal ve metod: Toplam 227 hasta çalışmaya dahil edildi. ESG, European Working Group on Sarcopenia in Older People 2 kriterlerine göre değerlendirildi ve beyaz küre sayısı (BKS), nötrofil sayısı (NS), lenfosit sayısı (LS), ortalama trombosit hacmi (OTH), trombosit dağılım genişliği (TDG), eritrosit dağılım genişliği (EDG), C-reaktif protein (CRP) ve glike hemoglobin (HbA1c) ile ilişkilendirildi. Veriler SPSS sürüm 27.0 (IBM Corp., Armonk, NY, ABD) kullanılarak analiz edildi.
Bulgular: Çalışma grubunu 85 kadın ve 142 erkek oluşturdu (ortalama yaş 70,2±4,9 yıl). Düşük ESG, 82 hastada gözlendi ve CRP ile güçlü bir korelasyon gösterdi (r=-0,504, p<0,001). BKS, NS, LS, nötrofil/lenfosit oranı ile EDG ve TDG de düşük HSG ile ilişkili bulundu. Buna karşılık, Mini Mental Durum Muayenesi, Katz Günlük Yaşam Aktiviteleri Bağımsızlık İndeksi, Lawton-Brody Enstrümantal Günlük Yaşam Aktiviteleri, Geriatrik Depresyon Ölçeği ve HbA1c ile anlamlı ilişki saptanmadı. Daha düşük Tinetti skorları ve daha uzun Zamanlı Kalk ve Yürü testi süreleri, azalmış ESG ile anlamlı şekilde ilişkiliydi. Lojistik regresyon analizinde düşük ESG için bağımsız öngördürücüler arasında OTH (OR=2.956, %95 GA=1.630-5.350, p<0,001) ve EDG (OR=0,549, %95 GA=0,360-0,850, p=0,007) öne çıkarken, ek olarak NS, LS ve CRP de istatistiksel olarak anlamlı bulundu.
Sonuç: ESG, inflamatuvar ve hematolojik parametrelerle yakından ilişkilidir ve bulgular T2DM’li yaşlı bireylerde fiziksel fonksiyonun basit ve değerli bir göstergesi olarak kullanılabileceğini desteklemektedir.

Anahtar Kelimeler

Kapsamlı geriatrik değerlendirme , El sıkma gücü , Inflammation , Yaşlı , Type-2 diabetes mellitus

Relationship between Handgrip Strength and Hematological Markers in Older Adult Patients with Type 2 Diabetes Mellitus

Öz

Background: This study evaluated the relationship between inflammatory and hematological parameters and handgrip strength (HGS) in older adults with type 2 diabetes mellitus (T2DM).
Materials and Methods: 227 patients were enrolled in the study. HGS was assessed according to the European Working Group on Sarcopenia in Older People 2 criteria and analyzed against white blood cell count (WBC), neutrophil count (NC), lymphocyte count (LC), mean platelet volume (MPV), platelet distribution width (PDW), red cell distribution width (RDW), C-reactive protein (CRP), and glycated hemoglobin (HbA1c). Datawere analyzed with SPSS version 27.0.
Results: The cohort included 85 women and 142 men (meanage 70.2±4.9 years). Low HGS was observed in 82 patients andwas strongly correlated with CRP (r=-0.504, p<0.001). WBC, NC,LC, neutrophil-to-lymphocyte ratio, RDW, and PDW were alsoassociated, while Mini-Mental Status Examination, Katz Indexof Independence in Activities of Daily Living, Lawton-BrodyInstrumental Activities of Daily Living, Geriatric Depression Scale,and HbA1c were not. Lower Tinetti scores and longer Timed Upand Go times correlated with reduced HGS. In logistic regressionanalysis, MPV (OR=2.956, 95% CI=1.630-5.350, p<0.001) andRDW (OR=0.549, 95% CI=0.360-0.850, p=0.007) emerged as thestrongest independent predictors of low HGS, while NC, LC, andCRP also reached statistical significance.
Conclusions: HGS is closely associated with inflammatory andhematological markers, supporting its role as a simple indicator ofphysical function in older adults with T2DM.

Anahtar Kelimeler

Comprehensive geriatric assessment , Handgripstrength , Inflammation , Older adult , Type-2 diabetes mellitus

Etik Beyan

This study was approved by the Non-Interventional Clinical Research Ethics Committee of Gaziantep Islam Science and Technology University (approval no: 650.48.24, date: June 18, 2025).

Kaynakça

• 1. Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119.
• 2. Bezerra CB, Pinho C, Saintrain MVL, Sodre A, Silva C, Doucet J. Characteristics of the clinical treatment of Brazilian and French older adults with diabetes. Diabetes Res Clin Pract. 2021;181:109088.
• 3. Forbes JM, Cooper ME. Mechanisms of diabetic complications. Physiol Rev. 2013;93(1):137-188.
• 4. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31.
• 5. Zhong P, Yang S, Liu R, Zhu Z, Zhang Y, Cheng W, et al. Handgrip strength and risks of diabetic vascular complications: Evidence from Guangzhou Diabetic Eye Study and UK cohorts. Br J Ophthalmol. 2024;109(1):157-164.
• 6. Wu H, Gu Y, Wang X, Meng G, Rayamajhi S, Thapa A, et al. Association Between Handgrip Strength and Type 2 Diabetes: A Prospective Cohort Study and Systematic Review With Meta-analysis. J Gerontol A Biol Sci Med Sci. 2023;78(8):1383-1391.
• 7. Jung YE, Kang KY. Elevated hs-CRP level is associated with depression in younger adults: Results from the Korean National Health and Nutrition Examination Survey (KNHANES 2016). Psychoneuroendocrinology. 2019;109:104397.
• 8. Salvatore T, Galiero R, Caturano A, Rinaldi L, Criscuolo L, Di Martino A, et al. Current Knowledge on the Pathophysiology of Lean/Normal-Weight Type 2 Diabetes. Int J Mol Sci. 2022;24(1):658.
• 9. Gasparyan AY, Sandoo A, Stavropoulos-Kalinoglou A, Kitas GD. Mean platelet volume in patients with rheumatoid arthritis: the effect of anti-TNF-alpha therapy. Rheumatol Int. 2010;30(8):1125-1129.
• 10. Reddy SK, Shetty R, Marupuru S, Yedavalli N, Shetty K. Significance of Platelet Volume Indices in STEMI Patients: A Case-Control Study. J Clin Diagn Res. 2017;11(4):LC05-LC07.
• 11. Sarkar S, Kannan S, Khanna P, Singh AK. Role of red blood cell distribution width, as a prognostic indicator in COVID-19: A systematic review and meta-analysis. Rev Med Virol. 2022;32(2):e2264.
• 12. Son DH, Song SA, Lee YJ. Association Between C-Reactive Protein and Relative Handgrip Strength in Postmenopausal Korean Women Aged 45-80 Years: A Cross-Sectional Study. Clin Interv Aging. 2022;17:971-978.
• 13. Alcohol Research: Current Reviews Editorial Staff. Drinking Patterns and Their Definitions. Alcohol Res. 2018;39(1):17-18.
• 14. Piercy KL, Polster M, Macias B, Vaux-Bjerke A. Physical Activity in Older Adults: What Every Internist Needs to Know. Am J Lifestyle Med. 2025;19(1):12-22.
• 15. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-198.
• 16. Santangelo I, Ahmad S, Liu S, Southerland LT, Carpenter C, Hwang U, et al. Examination of geriatric care processes implemented in level 1 and level 2 geriatric emergency departments. J Geriatr Emerg Med. 2022;3(4):[article ID].
• 17. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179-186.
• 18. Wen J, Fu CHY, Tosun D, Veturi Y, Yang Z, Abdulkadir A, et al. Characterizing Heterogeneity in Neuroimaging, Cognition, Clinical Symptoms, and Genetics Among Patients With Late-Life Depression. JAMA Psychiatry. 2022;79(5):464-474.
• 19. Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: The Mini Nutritional Assessment as part of the geriatric evaluation. Nutr Rev. 1996;54(1 Pt 2):S59-S65.
• 20. Köroğlu Ç. Alzheimer hastalarında yürüme ve denge değerlendirmesi: Karşılaştırmalı bir çalışma [Master’s thesis]. Pamukkale University; 2014.
• 21. Hendriks S, Huisman MG, Ghignone F, Vigano A, de Liguori Carino N, Farinella E, et al. Timed up and go test and long-term survival in older adults after oncologic surgery. BMC Geriatr. 2022;22:934.
• 22. Roberts HC, Denison HJ, Martin HJ, Patel HP, Syddall H, Cooper C, et al. A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age Ageing. 2011;40(4):423-429.
• 23. Little MO. Updates in nutrition and polypharmacy. Curr Opin Clin Nutr Metab Care. 2018;21(1):4-9.
• 24. Cumhur Cure M, Cure E, Yuce S, Yazici T, Karakoyun I, Efe H. Mean platelet volume and vitamin D level. Ann Lab Med. 2014;34(2):98-103.
• 25. Morioka K, Sato H, Kuboyama M, Yanagida A, Shoji A. Quantification of CRP in human serum using a handheld fluorescence detection system for capillary-based ELISA. Talanta. 2021;224:121725.
• 26. Parrinello CM, Selvin E. Beyond HbA1c and glucose: the role of nontraditional glycemic markers in diabetes diagnosis, prognosis, and management. Curr Diab Rep. 2014;14(11):548.
• 27. Marzetti E, Calvani R, Cesari M, Buford TW, Lorenzi M, Behnke BJ, et al. Mitochondrial dysfunction and sarcopenia of aging: from signaling pathways to clinical trials. Int J Biochem Cell Biol. 2013;45(10):2288-2301.
• 28. Pan HZ, Zhang L, Guo MY, Sui H, Li H, Wu WH, et al. The oxidative stress status in diabetes mellitus and diabetic nephropathy. Acta Diabetol. 2010;47 Suppl 1:71-76.
• 29. Li CW, Yu K, Shyh-Chang N, Jiang Z, Liu T, Ma S, et al. Pathogenesis of sarcopenia and the relationship with fat mass: descriptive review. J Cachexia Sarcopenia Muscle. 2022;13(2):781-794.
• 30. Franceschi C, Bonafè M, Valensin S, Olivieri F, De Luca M, Ottaviani E, et al. Inflamm-aging. An evolutionary perspective on immunosenescence. Ann N Y Acad Sci. 2000;908:244-254.
• 31. Broderick L, Hoffman HM. IL-1 and autoinflammatory disease: biology, pathogenesis and therapeutic targeting. Nat Rev Rheumatol. 2022;18(8):448-463.
• 32. Dupont J, Antonio L, Dedeyne L, O'Neill TW, Vanderschueren D, Rastrelli G, et al. Inflammatory markers are associated with quality of life, physical activity, and gait speed but not sarcopenia in aged men (40-79 years). J Cachexia Sarcopenia Muscle. 2021;12(6):1818-1831.
• 33. Beaudart C, Rolland Y, Cruz-Jentoft AJ, Bauer JM, Sieber C, Cooper C, et al. Assessment of Muscle Function and Physical Performance in Daily Clinical Practice: A position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Calcif Tissue Int. 2019;105(1):1-14.
• 34. Borda MG, Lafuente-Sanchis P, Patricio Baldera J, Tarazona-Santabalbina FJ, Chavarro-Carvajal DA, Salazar-Londono S, et al. Assessing Neutrophil-to-Lymphocyte Ratio as a Nutritional Indicator in Community-Dwelling Older Adults. Arch Med Res. 2024;55(4):103003.
• 35. Bektan Kanat B, Suzan V, Ulugerger Avci G, Unal D, Emiroglu Gedik T, Suna Erdincler D, et al. Systemic inflammatory response index and monocyte-to-high density lipoprotein ratio — new biomarkers remarking the inflammation in primary sarcopenia: The SIMPS study. Bratisl Lek Listy. 2024;125(5):331-336.
• 36. Bohannon RW, Larkin PA, Cook AC, Gear J, Singer J. Decrease in timed balance test scores with aging. Phys Ther. 1984;64(7):1067-1070.
• 37. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412-423.
• 38. Izzo A, Massimino E, Riccardi G, Della Pepa G. A Narrative Review on Sarcopenia in Type 2 Diabetes Mellitus: Prevalence and Associated Factors. Nutrients. 2021;13(1):183.
• 39. Giha HA, Alamin OAO, Sater MS. Diabetic sarcopenia: metabolic and molecular appraisal. Acta Diabetol. 2022;59(8):989-1000.