The Relationship Between Osteoarthritis and Sarcopenia in Geriatric Diabetic Patients

Objectives: Osteoarthritis is a common disease affecting the quality of life in the elderly population. Osteoarthritis is a painful condition commonly encountered in patients aged 65 years and older and it may cause muscle weakness. Sarcopenia is a condition that has an increasing prevalence in the elderly population. The present study evaluated the relationship between sarcopenia and osteoarthritis.
Methods: The study included 100 patients aged 65 years and older who were diagnosed with diabetes mellitus. The patients were divided into two groups as Group 1 and Group 2. Group 1 was composed of 50 patients with diabetes and osteoarthritis and Group 2 was composed of 50 patients with diabetes but without osteoarthritis. A detailed medical history was obtained from all patients and all patients underwent physical examination. The get-up and go test was performed, handgrip strength was measured with a hand dynamometer, bioimpedance analysis was performed, and mid-upper arm circumference, calf circumference and waist circumference were measured, and laboratory tests including complete blood count, biochemical nutritional parameters, liver and kidney function tests, and erythrocyte sedimentation rate were ordered. The Kellgren and Lawrence grading system was used to evaluate the severity of osteoarthritis and the skeletal muscle mass index was used to evaluate the muscle mass. These parameters were compared between the two groups.
Results: Of the study participants, 1% had severe sarcopenia, 22% had moderate sarcopenia, and 77% did not have sarcopenia. Albumin (p=0.013), magnesium (p=0.038), total protein (0.004), erythrocyte sedimentation rate (p=0.047), hemoglobin level (p=0.018), muscle strength (p=0.046), height (p=0.033), and muscle mass (p<0.05) were significantly different in patients with osteoarthritis compared to patients without osteoarthritis. Patients with osteoarthritis achieved poorer results on the get-up and go test (p=0.014), and mid-upper arm circumference (p=0.028), and calf circumference (p=0.016) were lower in this group. There was a negative moderate correlation between the muscle mass and the Kellgren and Lawrence grade (p<0.05, r: −0.405), whereas there was a positive moderate correlation between sarcopenia index and the Kellgren and Lawrence grade (p<0.05, r: 0.320) in patients with osteoarthritis.
Conclusion: The present study is the first to evaluate the relationship between sarcopenia and osteoarthritis in geriatric diabetic patients. The present study found a significant relationship between osteoarthritis and sarcopenia in geriatric patients with type II diabetes mellitus. The authors suggest that pain associated with osteoarthritis results in immobility, decrease in functional performance, and thus development of sarcopenia.

Geriatrik Diyabetik Hastalarda Osteoartrit Ýle Sarkopeni Arasýndaki Ýliþki

Giriþ
Osteoartrit (OA), yaþlý populasyonda sýk görülen ve hayat kalitesini etkileyen bir hastalýktýr. 65 yaþ ve üstü hastalarda sýk karþýlaþýlan aðrýlý bir durum olan OA bireylerin kaslarýný kullanmalarýnda azalmaya neden olabilir. Sarkopeni ise yaþlý populasyonda sýklýðý artmakta olan bir durumdur. Bu çalýþmada diyabetik yaþlýlarda sarkopeni ve osteoartrit arasýndaki iliþkiyi araþtýrdýk.
Materyal-Metot
Çalýþmaya 65 yaþ ve üstü diyabetes mellitus tanýsý olan 100 hasta alýndý. Hastalar iki ayrý gruba ayrýldý. Birinci gruba diyabeti ve osteoartriti olan 50 hasta alýnýrken ikinci gruba diyabeti olan ancak osteoartriti olmayan 50 hasta alýndý. Tüm hastalardan ayrýntýlý anamnez alýnýp, hastalarýn fizik muayeneleri yapýldý. Her iki grupta kalk yürü testi, el dinamometresi, bio-empedans, üst kol çevresi, baldýr çevresi ve bel çevresi ölçümleri yapýlýp, hemogram, biyokimyasal nutrisyon parametreleri, karaciðer ve böbrek fonksiyon testleri, sedimantasyon gibi tetkikler istendi. Kellgren Lawrence sýnýflamasý, sarkopeni indeksi (SMMI) skorlarý hesaplandý. Bu deðerler her iki grupta karþýlaþtýrýldý.
Bulgular
Çalýþmaya katýlan hastalarýn % 1’inde ciddi sarkopeni ve %22’sinde orta düzey sarkopeni saptanýrken %77’si non-sarkopenikti. Osteoartriti olan grupta olmayanlara kýyasla albümin (p =0,013), magnezyum (p =0,038), total protein (p =0,004), sedimantasyon (p =0,047), hemoglobin düzeyi (p =0,018), kas gücü (p =0,046), boy (p =0,033) ve kas kitlesi (p <0,05) anlamlý farklýydý. Yine osteoartriti olan hastalarda kalk yürü testi daha kötü (p=0,014), üst kol çevresi (p=0,028), baldýr çevresi (p=0,016) daha düþük bulundu. Osteoartrit olan hastalarda muscle mass ile Kellgren Lawrence sýnýflamasý arasýnda negatif orta dereceli korelasyon (p<0,05, r: -0,405) ve sarkopeni indeksi ile Kellgren Lawrence sýnýflamasý arasýnda pozitif orta dereceli korelasyon (p<0,05, r: 0,320) saptadýk.
Sonuç
Çalýþmamýz geriatrik diyabetik hastalarda sarkopeni ile osteoartrit arasýndaki ilikþiyi irdeleyen ilk çalýþma olmasý nedeniyle ilginçtir. Çalýþmamýzda T2DM tanýlý geriatrik hastalarda orteoartrit ile sarkopeni arasýnda anlamlý bir iliþki saptadýk. Aðrýlý bir durum olan osteoartritin hastalarda hareketsizliðe, iþlevsel performansta azalmaya ve buna baðlý olarak sarkopeniye neden olduðu kanaatindeyiz. (SETB-2020-12-273)