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

Öz

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.

Anahtar Kelimeler

• diabetes mellitus
• rheumatoid arthritis
• fibromyalgia
• vitamin d

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

Öz

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.

Anahtar Kelimeler

• Diyabet
• Fibromiyalji
• D vitamini
• Romatoid artrit

Kaynakça

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