FİBROMİYALJİ TEDAVİSİ ALAN HASTALARDA 25-HİDROKSİ VİTAMİN D DÜZEYLERİNİN DEĞERLENDİRİLMESİ

Yıl 2022, Cilt: 23 Sayı: 3, 300 - 304, 18.07.2022

Harun Düğeroğlu

https://doi.org/10.18229/kocatepetip.902645

Öz

AMAÇ: Bu çalışma ile fibromiyalji tedavisi alan hastalarda 25-hidroksi vitamin D (25(OH)D) düzeylerinin değerlendirilmesi amaçlandı.
GEREÇ VE YÖNTEM: Çalışmada Ocak 2018 - Mart 2020 tarihleri arasında hastanemizde diğer sistemik hastalıklar ekarte edilerek, ACR (American College of Rheumatolog) 2010 tanı kriterlerine göre fibromiyalji tanısı konulan ve tedavi alan 18 yaş ve üstü 244 hastanın verileri ile kontrol grubu olarak 120 hastanın verileri retrospektif olarak tarandı. Fibromiyalji tedavisi alan hastalar ve kontrol grubu hastalar serum 25-hidroksi vitamin D düzeylerine göre üç gruba ayrıldı (eksik, yetersiz ve normal). Gruplar arasında istatistiksel olarak anlamlı bir fark olup olmadığı analiz edildi. Ayrıca, hasta grubunun vitamin D düzeyleri, yaş aralıklarına göre değerlendirilmesi yapıldı. P değeri 0.05’den küçük olması anlamlı kabul edildi.
BULGULAR: Çalışmaya alınan 244 fibromiyalji tanılı hastanın % 66,4 (n=162)’ü kadın, %33,6 (n=82)’ı erkek idi. Hasta grubunun ortalama serum 25(OH)D düzeyi 16,2±12,7 ng/ml olarak hesaplandı. Kontrol grubu olarak alınan 120 hastanın ise, %70 (n=84)’i kadın, %30 (n=36)’u erkek idi. Kontrol grubunun ortalama serum 25(OH)D düzeyi ise 24,6±13,1 ng/ml olarak hesaplandı. Fibromiyalji tedavisi alan hasta grubu ile kontrol grubu hastalarının cinsiyetleri ile serum 25(OH)D düzeylerinin istatistiksel olarak karşılaştırılması yapıldığında, gruplar arasında anlamlı fark bulundu (p=0.017). Ayrıca, hasta grubunda en düşük serum 25(OH)D düzeyini 36-50 yaş aralığında saptadık.
SONUÇ: Fibromiyalji tedavisi alan hastalarda yüksek oranda vitamin D eksikliği ve yetersizliği görülmektedir. Bu nedenle, vitamin D seviyesi düşük olan hastalara yeterli düzeyde replasman yapılmasının hastaların kas-iskelet sistemi semptomlarında ve şikayetlerinde belirgin azalma sağlayacaktır.

Anahtar Kelimeler

Fibromiyalji, 25-hidroksi vitamin D, Yetersizlik.

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

yok

EVALUATION OF 25-HYDROXY VITAMIN D LEVELS IN PATIENTS TREATED FOR FIBROMYALGIA

Öz

OBJECTIVE: The aim of this study was to evaluate 25-hydroxy vitamin D (25(OH)D) levels in patients receiving fibromyalgia treatment.
MATERIAL AND METHODS: In the study, the data of 244 patients aged 18 years and older who were diagnosed with fibromyalgia according to the ACR (American College of Rheumatologist) 2010 diagnostic criteria in our hospital between January 2018 and March 2020, and other systemic diseases were excluded, and the data of 120 patients as the control group were etrospectively reviewed. The patients who received fibromyalgia treatment and the patients in the control group were divided into three groups according to their serum 25-hydroxy vitamin D levels (deficient, insufficient and normal). It was analysed whether there was a statistically significant difference between the groups. In addition, vitamin D levels of the patient group were evaluated according to age ranges. P value less than 0.05 was considered as significant.
RESULTS: Of the 244 patients diagnosed with fibromyalgia included in the study, 66.4% (n=162) were female and 33.6% (n=82) were male. The mean serum 25(OH)D level of the patient group was calculated as 16.2±12.7 ng/ml. Of the 120 patients taken as the control group, 70% (n=84) were female and 30% (n=36) were male. Mean serum 25(OH)D level of the control group was calculated as 24.6±13.1 ng/ml. When the gender and serum 25(OH)D levels of the patients in the fibromyalgia treatment group and the control group were compared statistically, a significant difference was found between the groups (p=0.017). In addition, we found the lowest serum 25 (OH) D level in the patient group between the ages of 36-50.
CONCLUSIONS: High levels of vitamin D deficiency and insufficiency are observed in patients receiving fibromyalgia treatment. Therefore, adequate replacement in patients with low vitamin D levels will provide a significant decrease in musculoskeletal system symptoms and complaints.

Anahtar Kelimeler

Fibromyalgia, 25-hydroxy vitamin D, Deficiency.

Proje Numarası

yok

Kaynakça

• 1. Clauw DJ. Fibromyalgia: a clinical review. JAMA. 2014;311(15):1547–55.
• 2. Wolfe F, Smythe HA, Yunus MB, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Arthritis Rheum. 1990;33:160-72.
• 3. Topbaş M, Çakırbay H, Güleç H, ve ark. The prevalence of fibromiyalgia in woman aged 20-64 in Turkey. Scand J Rheumatol. 2005;34:140-4.
• 4. Wolfe F, Clauw DJ, Fitzchar!es MA, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken). 2010;62:600-1O.
• 5. Bhatty SA, Shaikh NA, Irfan M, et al. Vitamin D deficiency in fibromyalgia. J Pak Med Assoc. 2010;60: 949-51.
• 6. Binkley N, Ramamurthy R, Krueger D. Low Vitamin D Status: Definition, Prevalence, Consequences, and Correction. Rheumatic Disease Clinics of North America. 2012;38(1):45-59.
• 7. Olama SM, Senna MK, Elarman MM, Elhawary G. Serum vitamin D level and bone mineral density in premenopausal Egyptian women with fibromyalgia. Rheumatol Int. 2013;33(1):185-92.
• 8. Altındağ O, Öğüt E, Gür A, Gürsoy S, Günay M. Serum vitamin D level and its relation with clinical parameters in fibromyalgia as a neuropathic pain. Orthop Muscular Syst. 2014;3:171.
• 9. Okyay R, Koçyiğit B, Gürsoy S. Vitamin D levels in women with fibromyalgia and relationship between pain, tender point count and disease activity. Acta Med Mediterr. 2016;32:243-47.
• 10. Masuko K. The multifaceted effects of vitamin D and its potential contribution to rheumatoid arthritis. British Journal of Medicine and Medical Research. 2014;4(8):1680-90.
• 11. Cantorna MT, Zhu Y, Froicu M, Wittke A. Vitamin D status, 1, 25-dihydroxyvitamin D3, and the immune system. The American Journal of Clinical Nutrition. 2004;80(6):1717-20.
• 12. Makrani AH, Afshari M, Ghajar M, Forooghi Z, Moosazadeh M. Vitamin D and fibromyalgia: a meta-analysis. Korean J Pain. 2017;30(4):250-7.
• 13. Armstrong DJ, Meenagh GK, Bickle I, et al. Vitamin D deficiency is associated with anxiety and depression in fibromyalgia. Clin Rheumatol. 2007;26:551–4.
• 14. Mascarenhas R, Mobarhan S. Hypovitaminosis D-inducid pain. Nutrition Reviews. 2004;62:354-9.
• 15. Wu Z, Malihi Z, Stewart AW, Lawes CM, Scragg R. The association between vitamin D concentration and pain: a systematic review and meta-analysis. Public Health Nutr. 2018;21(11):2022-37.
• 16. Sarıfakıoğlu B, Yalbuzdağ SA, Güzelant AY, Afsa SI, Ustaömer K. Vitamin D related musculoskeletal system findings. Turk J Osteoporos. 2015;21:113-7.
• 17. Hollick MF. Vitamin D: a millenium perspective. J Cell Biochem. 2003;20:239-42.
• 18. Akkuş S, Tamer MN, Yorgancıgil H. A case of osteomalacia mimicking ankylosing spondylitis. Rheumatol Int. 2001;20:239-42.
• 19. Al-Allaf AW, Mole PA, Paterson CR, Pullar T. Bone health in patients with fibromiyalgia. Rheumatology. 2003;42:1202-6.
• 20. Tandeter H, Grynbaum M, Zuili I, Shany S, Shvartzman P. Serum 25-OH vitamin D levels in patients with fibromyalgia. Isr Med Assoc J. 2009;11:339-42.
• 21. Doğru A, Balkarlı A, Çobankara V, Tunç SE, Şahin M. Effects of Vitamin D Therapy on Quality of Life in Patients with Fibromyalgia. Eurasian J Med. 2017;49(2):113-7.
• 22. Yılmaz R, Sallı A, Cingöz HT, Küçükşen S, Uğurlu H. Efficacy of D replacement therapy on patients with chronic nonspecific widespread musculoskeletal pain with vitamin D deficiency. Int J Rheum. 2016;19(12):1255-62.
• 23. Matthana MH. The relation between vitamin d deficiency and fibromyalgia syndrome in women. Saudi Med J. 2011;32:925–9.
• 24. Huisman AM, White KP, Algra A, et al. Vitamin D levels in women with sistemic lupus erythematosus and fibromiyalgia. J Rheumatol. 2001;28:2535-39.
• 25. Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc. 2003;78:1463-70.
• 26. Zuberi LM, Haque N, Jabbar A, Habib A. Vitamin D Deficiency in Ambulatory patients. J Pac Med Assoc. 2008;58:482-4.