Asemptomatik primer hiperparatiroidizm hastalarında sarkopeninin değerlendirilmesi
[ X ]
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Primer hiperparatiroidi (PHPT), parathormonun(PTH) aşırı sekresyonu ile karakterize olan, kalsiyum (Ca) dengesinde bozukluk ile sonuçlanan endokrin bir hastalıktır. Asemptomatik PHPT modern batı toplumlarında PHPT'nin baskın fenotipini oluşturmaktadır. Sarkopeni ise düşme, kırıklar, fiziksel engellilik ve mortalite dahil olmak üzere artan olumsuz sonuç olasılığı ile ilişkili ilerleyici ve genelleşmiş bir iskelet kası bozukluğudur. Bu çalışma ile güncel sarkopeni kriterleri doğrultusunda asemptomatik primer hiperparatiroidizm hastalarının kontrol grubu bireylerden farkı olup olmadığının araştırılması planlanmıştır. Gereç ve Yöntem: Çalışmaya 1 Temmuz -1 Ekim 2021 tarihleri arasında Kırıkkale Üniversitesi Tıp Fakültesi endokrin polikliniğinde asemptomatik primer hiperparatiroidizm tanısıyla takip edilen 35 hasta ile iç hastalıkları polikliniğine başvuran hastalığı olmayan, benzer yaş, cinsiyet ve vitamin D düzeyine sahip 35 kontrol grubu birey dahil edildi. Her iki grupta da antropometrik ölçümler,baskın elde kavrama gücü, 4 metre yürüme hızı ölçüldü. Biyoelektrik-Empedans Analizi (BİA) yardımı ile vücut kompozisyon analizi yapıldı. İskelet kası kütle indeksi (SMI) ve visseral adiposite indeksi hesaplandı. Bulgular: Çalışmaya yaş ortalaması 56,1±7,59 yıl olan toplam 70 birey dahil edildi. 35 kişi kontrol ve 35 kişi asemptomatik primer hiperparatiroidizm (APH) hastasıydı. Kontrol grubunun yaş ortalaması 55,6±6,61 yıl, APH grubunun 56,5±8,54 yıl olup istatistiksek açıdan benzer bulundu (p=0,640). Her iki grupta da kadın (%91,4) ve erkek (%8,6) oranı benzerdi(p=0,999). APH hastalarının medyan vitamin D değeri 12 IU(Uluslararası birim)( IQR: 7-15), kontrol grubunun 13 IU (IQR:9-18)olup istatistiksel açıdan benzerdi (p=0,556). Kontrol ve APH grubunun SMI(kg/m2) (p=0,401), yürüme hızı (m/sn) (p=0,525) ve 4 metre yürüyüş süresi (sn) (p=0,620) ölçümleri istatistiksel açıdan benzerdi. APH hastalarının medyan el kavrama gücü (20,8 kg [IQR: 17,9-23]) kontrol grubuna göre (24 kg [IQR: 20,1-27]) istatistiksel olarak daha düşüktü (p=0,026). Kontrol ve APH hastalarının visseral adiposite indeksi ve faz açısı değerleri karşılaştırıldığında istatistiksel olarak anlamlı fark olmadığı saptandı (p=0,356 ve p=0,953). Sonuç: Bu çalışmada asemptomatik primer hiperparatiroidizm hastalarında güncel sarkopeni kriterleri doğrultusunda kas gücünde istatistiksel olarak anlamlı düzeyde azalma olduğu, kas miktarı ve yürüme hızında anlamlı düzeyde fark olmadığını tespit ettik. APH ile sarkopeni arasındaki ilişki hakkında daha fazla bilgi sahibi olabilmek için uzun dönem verilerin takip edildiği, çok merkezli çalışmalara ihtiyaç vardır. Anahtar Kelimeler: Primer hiperparatiroidizm, Sarkopeni, BİA, el kavrama gücü, yürüme hızı
Objective: Primary hyperparathyroidism (PHPT) is an endocrine disease characterized by excessive secretion of parathormone (PTH) and resulting in imbalance of calcium (Ca) metabolism. Asymptomatic PHPT constitutes the dominant phenotype of PHPT in modern western societies. Sarcopenia is a progressive and generalized skeletal muscle disorder associated with an increased likelihood of adverse outcomes, including falls, fractures, physical disability, and mortality. With this study, it was planned to investigate whether asymptomatic primary hyperparathyroidism patients differed from the control group in terms of current sarcopenia criteria. Materials and Methods: The study included 35 patients who were followed up with the diagnosis of asymptomatic primary hyperparathyroidism in the endocrine polyclinic of Kırıkkale University Faculty of Medicine between July 1 and October 1, 2021, and 35 control group individuals with similar age, gender and vitamin D levels who applied to the internal medicine outpatient clinic without any disease. . Anthropometric measurements, grip strength in the dominant hand, and walking speed of 4 meters were measured in both groups. Body composition analysis was performed with the help of Bioelectrical-Impedance Analysis (BIA). Skeletal muscle mass index (SMI) and visceral adipocyte index were calculated. Results: A total of 70 patients with a mean age of 56.1±7.59 years were included in the study. 35 people were controls and 35 people were asymptomatic primary hyperparathyroidism (APH) patients. The mean age of the control group was 55.6±6.61 years, and the EPH group was 56.5±8.54 years, statistically similar (p=0.640). The ratio of females (91.4%) and males (8.6%) was the same in both groups (p=0.999). It was observed that the median vitamin D value of EPH patients was 12 (IQR: 7-15) and the control group was 13 (IQR: 9-18), which was not statistically significant (p=0.556). The SMI (p=0.401), walking speed (p=0.525) and four-meter walking time (p=0.620) measurements of the control and EPH groups were statistically similar. The median hand flu score of EPH patients (20.8 [IQR: 17.9-23]) was statistically lower than the control group (24 [IQR: 20.1-27]) (p=0.026). When the visceral adipocyte and face angle values of the control and EPH patients were compared, it was found that there was no statistically significant difference (p=0.356 and p=0.953). Conclusion: In our study, we found that there was a statistically significant decrease in muscle strength in asymptomatic primary hyperparathyroidism patients in line with current sarcopenia criteria, and there was no significant difference in muscle amount and walking speed. The lack of decrease in muscle amount and physical performance may be related to the small sample size. Further studies are needed to learn more about the relationship between APH and sarcopenia. Keywords: Primary hyperparathyroidism, Sarcopenia, BIA, Hand grip, Walking speed
Objective: Primary hyperparathyroidism (PHPT) is an endocrine disease characterized by excessive secretion of parathormone (PTH) and resulting in imbalance of calcium (Ca) metabolism. Asymptomatic PHPT constitutes the dominant phenotype of PHPT in modern western societies. Sarcopenia is a progressive and generalized skeletal muscle disorder associated with an increased likelihood of adverse outcomes, including falls, fractures, physical disability, and mortality. With this study, it was planned to investigate whether asymptomatic primary hyperparathyroidism patients differed from the control group in terms of current sarcopenia criteria. Materials and Methods: The study included 35 patients who were followed up with the diagnosis of asymptomatic primary hyperparathyroidism in the endocrine polyclinic of Kırıkkale University Faculty of Medicine between July 1 and October 1, 2021, and 35 control group individuals with similar age, gender and vitamin D levels who applied to the internal medicine outpatient clinic without any disease. . Anthropometric measurements, grip strength in the dominant hand, and walking speed of 4 meters were measured in both groups. Body composition analysis was performed with the help of Bioelectrical-Impedance Analysis (BIA). Skeletal muscle mass index (SMI) and visceral adipocyte index were calculated. Results: A total of 70 patients with a mean age of 56.1±7.59 years were included in the study. 35 people were controls and 35 people were asymptomatic primary hyperparathyroidism (APH) patients. The mean age of the control group was 55.6±6.61 years, and the EPH group was 56.5±8.54 years, statistically similar (p=0.640). The ratio of females (91.4%) and males (8.6%) was the same in both groups (p=0.999). It was observed that the median vitamin D value of EPH patients was 12 (IQR: 7-15) and the control group was 13 (IQR: 9-18), which was not statistically significant (p=0.556). The SMI (p=0.401), walking speed (p=0.525) and four-meter walking time (p=0.620) measurements of the control and EPH groups were statistically similar. The median hand flu score of EPH patients (20.8 [IQR: 17.9-23]) was statistically lower than the control group (24 [IQR: 20.1-27]) (p=0.026). When the visceral adipocyte and face angle values of the control and EPH patients were compared, it was found that there was no statistically significant difference (p=0.356 and p=0.953). Conclusion: In our study, we found that there was a statistically significant decrease in muscle strength in asymptomatic primary hyperparathyroidism patients in line with current sarcopenia criteria, and there was no significant difference in muscle amount and walking speed. The lack of decrease in muscle amount and physical performance may be related to the small sample size. Further studies are needed to learn more about the relationship between APH and sarcopenia. Keywords: Primary hyperparathyroidism, Sarcopenia, BIA, Hand grip, Walking speed
Açıklama
Tıp Fakültesi, İç Hastalıkları Ana Bilim Dalı
Anahtar Kelimeler
Endokrinoloji ve Metabolizma Hastalıkları, Endocrinology and Metabolic Diseases, İç Hastalıkları
