Does polyneuropathy have effects on lower extremity muscle strength, walking performance and activities of daily living of patients with Type 2 Diabetes Mellitus? A prospective controlled study

Bu çalışmanın amacı ; polinöropatisi(PNP) olan ve olmayan Tip 2 Diyabetes Mellitus(DM) hastalarının alt ekstremite kas güçlerinin izokinetik yöntemlerle değerlendirilmesi ve hastalardaki olası kas gücü kayıplarının, hastaların günlük yaşamlarını ve yaşam kalitelerini ne düzeyde etkilediğini sağlıklı kontrollerle karşılaştırarak saptamaktı. Araç ve Yöntemler: Bu prospektif kontrollü çalışmamıza , 40-70 yaş arası 60 Tip 2 DM’li ve 30 sağlıklı birey dahil edilmiştir. Tip 2 DM’li 60 hastadan PNP’si olan 30 hasta Grup 1’i, PNP’si olmayan 30 hasta ise Grup 2’yi oluşturacak şekilde gruplandırıldı.Tüm katılımcılara yaşam kalitesini değerlendirmek amacıyla Kısa Form-36 (SF 36) kullanıldı. Fonksiyonel değerlendirme için merdiven inip çıkma testi (Stair Climb test=SCT) ve zamanlı kalk yürü testi (The Timed Up & Go=TUG) yapıldı. Ayrıca tüm katılımcıların kas gücü Biodex marka izokinetik cihaz yardımıyla ölçüldü..Bulgular:Çalışmaya alınan Tüm DM’li hastaların kas gücü sağlıklı gruba göre düşük,yaşam kalitesini ölçen SF-36 bütün paremetreleri düşük olarak bulundu. Bu farklılık istatistiksel olarak anlamlıydı(p<0.01).Ayrıca tüm DM’li hastaların TUG ve SCT testlerini sağlıklı gruba göre daha uzun sürede tamamlandığı belirlendi. (p<0.05).Sonuç:Bu çalışmanın sonuçlarına göre, polinöropati varlığından bağımsız olarak DM'nin kas gücünde azalmaya neden olduğu ve bunun da hastaların yaşam kalitesini etkilediğini göstermiştir.The aim of this study was to evaluate the lower extremity muscle strength of type 2 Diabetes mellitus (DM) patients with and without polyneuropathy (PNP) using isokinetic methods and to determine the effect of possible losses of muscle strength on patients' daily lives and quality of life. Materials and Methods: 60 patients with type 2 DM patients and 30 healthy individuals aged 40-70 years were included in this prospective controlled study. Of the 30 DM patients with PNP were defined as Group 1, 30 DM patients without PNP as Group 2 and 30 healthy individuals were defined as Group 3. Short Form-36 (SF 36) was used to evaluate the quality of life for all participants. Stair climb test (SCT) and timed up and go test (TUG) were performed for functional evaluation. The muscle strength of all participants was measured with the aid of a Biodex isokinetic device. Results: SF-36 parameters measuring quality of life and muscle strength were significantly lower in DM patients compared to the control group. Also, TUG and SCT tests of patients with DM were significantly longer than the control group. There was no significant difference between DM groups with and without PNP in terms of muscle strength, SF-36 parameters, TUG and SCT tests. Conclusions: This study showed that DM affects the quality of life of patients by causing a decrease in muscle strength independent from the presence of polyneuropathy

The changes of mean platelet volume and platelet distribution width in patients with rheumatoid arthritis and their correlation with disease activity

Aims: The link between inflammation and platelet activation was already proven. Only a few studies have been reported using platelet indices (platelet count (PC), mean platelet volume (MPV) and platelet distribution width (PDW)) as an indicator of acute phase response for assessment of disease activity. The aim of this study was to evaluate the PC, MPV and PDW trends in patients with rheumatoid arthritis (RA) comparing with control group. We also investigated whether these parameters were associated with disease activity score (DAS28-CRP) in RA patients. Materials and methods: Ninety consecutive RA patients fulfilling American College of Rheumatology criteria (RA group) and 52 rheumatic disease free participants (control group) were included this study. PC, MPV and PDW values of RA group compared with controls. Correlation tests were used in order to evaluate the relationship between the DAS28-CRP scores and PC as well as MPV and PDW. Results: We found significantly higher MPV and lower PDW values in the RA group when compared with controls. There were negative correlations between DAS28-CRP and MPV (r=-0,231, p=0,029) also PDW (r=-0,216, p=0,041) while correlation between DAS28-CRP and platelet count was not significant statistically. Conclusion: This study demonstrated that platelet indices such as MPV and PDW may provide helpful information for assessment of disease activity in patients with RA