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    Association Between Prognostic Nutritional Index and Bone Mineral Density, Fracture Risk Assessment (FRAX) Tool, and Disability in Patients with Postmenopausal Osteopenia/Osteoporosis: A Cross-Sectional Study
    (Aves, 2024) Baday-Keskin, Dilek; Hepsen, Sema; Uz, Cuma
    Objective: To evaluate the relationship between prognostic nutritional index (PNI) and bone mineral density (BMD) values and disability in patients with osteo penia /oste oporo sis. Methods: Between January 2022 and January 2023, 106 postmenopausal women with osteopenia (n = 54) and osteoporosis (n = 52) were included in the study. Patients with a disease or medication causing secondary osteoporosis were excluded. Bone mineral density was evaluated using dual- energy X-ray absorptiometry. Nutritional status was measured using the PNI, which was calculated using total lymphocyte count and serum albumin levels. The Health Assessment Questionnaire Disability Index (HAQ-DI) was used to evaluate disability. Results: The mean age of the participants was 63.78 +/- 7.53 years. Prognostic nutritional index was positively correlated with total hip BMD values (r r = 0.217, P = .029) and total hip T-scores (r r = 0.207, P = .037) and negatively correlated with Fracture Assessment Tool Model (FRAX)-major fracture risk (r r = - 0.399, P < .001), FRAX-hip fracture risk (r r = - 0.300, P = .002), and HAQ-DI scores (r r =--0.474, - 0.474, P < .001). The mean PNI was lower in patients with a history of falls than in those without falls (P P < .001). The mean PNI was lower in patients with a history of osteoporotic fractures than in those without a fracture history (P P = .007). Multivariate linear regression analyses showed that PNI was the only independent variable for HAQ-DI (B B = - 0.040, P < .001) (R2 R2 = 0.17). Conclusion: Using PNI in clinical practice may be beneficial because of its association with BMD values and for predicting the independence of patients with osteo penia /oste oporo sis. If a disability is detected, a multidisciplinary approach should be considered, including rehabilitation and improvement of nutritional condition.
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    The assessment of neuropathic pain in patients with prediabetes
    (Elsevier Sci Ltd, 2023) Hepsen, Sema; Keskin, Dilek Baday; Cakal, Erman
    Aims: Neuropathic pain is associated with several clinical conditions, including anxiety, depression, sleep dis-orders, and decreased quality of life; however, less evaluated in prediabetes. This study aims to assess neuro-pathic pain through validated diagnostic tools in prediabetes.Methods: One hundred and seventy-two patients with prediabetes and 170 controls were included in this cross-sectional study. The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) Pain Scale and Douleur Neuropathique 4 Questions (DN4) were used to evaluate neuropathic pain. The Visual Analog Scale (VAS) was used to estimate pain intensity.Results: Twenty-three (13.4%) and 12 (7%) patients with prediabetes were diagnosed with neuropathic pain using DN4 and LANSS questionnaires, respectively. Neuropathic pain rates of the patients were higher than controls with two pain scales (p < 0.001). VAS scores were higher in prediabetes group than in controls (p = 0.021). LANSS, DN4, and VAS scores were positively correlated with HbA1c level (r = 0.184, p = 0.016; r = 0.180, p = 0.018; r = 0.188, p = 0.014, respectively). LANNS and DN4 scores were higher in female patients than in males (p < 0.001).Conclusions: Neuropathic pain was increased in prediabetes by DN4 and LANNS questionnaires. An appropriate diagnosis of neuropathic pain in prediabetes may prevent patients from different pain-related clinical conditions.
  • Küçük Resim
    Öğe
    The Relationship Between Hand Function and Activities of Daily Living in Patients with Hypothyroidism
    (Aves, 2023) Hepsen, Sema; Keskin, Dilek Baday; Çakal, Erman
    Objective: This study aimed to evaluate hand function and hand function-related factors in patients with hypothyroidism and to investigate the relationship between hand function and activities of daily living. Methods: This cross-sectional study included 103 patients with hypothyroidism (53 with Hashimoto thyroiditis, 50 with postoperative hypothyroidism) and 50 controls. Hand function was evaluated with the Duruoz Hand Index, and the Nottingham Extended Activities of Daily Living Scale was used to assess activities of daily living. Results: The mean Duruoz Hand Index scores were higher in the Hashimoto group (1.70 +/- 4.71) (P =.02) and postsurgical group (2.16 +/- 4.37) (P =.002) than in the control group (0.24 +/- 1.02). The median Nottingham Extended Activities of Daily Living Scale score was 65 (45-66) in patients with Hashimoto thyroiditis, 63 (43-66) in patients with postsurgical hypothyroidism, and 66 (46-66) in the control group (P =.009). The difference was statistically significant between the control group and Hashimoto (P =.037) and postsurgical (P =.001) groups. The cut-off value of the Nottingham Extended Activities of Daily Living Scale determined with receiver operating characteristics analysis for poor and good activities of daily living status was 63.5 with a sensitivity of 70% and a specificity of 54% (area under the curve: 0.643, 95% Cl: 0.553-0.733, P =.004) for this study. Logistic regression analysis showed that Duruoz Hand Index (B = -0.695, P =.011) and female gender (B = -2.477, P =.028) were predictive variables for activities of daily living (R-2 = 0.43). Conclusion: Hand function was worse, and activities of daily living were lower in patients with hypothyroidism. Since poor hand function may affect activities of daily living, clinicians should routinely assess hand function and activities of daily living in patients with hypothyroidism. A multidisciplinary approach including rehabilitation programs, must be considered if hand dysfunction is detected.