Diabetes Mellitus ve Kas İskelet Sistemi
Özet
GİRİŞ: Diabetes mellitus (DM) iskelet kas sistemi ve eklemlerle ilişkili çok sayıda komplikasyonla birliktedir. Bu bölümde, diyabetin kas-iskelet sistemi üzerine etkileri anlatılmıştır.
GELİŞME: DM ile ilişkili kas iskelet hastalıkları; el, omuz, alt ekstremite ve omurga bölgesini etkileyen hastalıklar olarak gruplandırılmıştır. Karpal tünel sendromu, dupuyturen kontraktürü, fleksör tenosinovit, diabetik sklerodaktili , kısıtlı eklem mobilitesi DM bağlı el tutulumlarındandır. DM bağlı omuz tutulumlarından, adeziv kapsülit, rototor kuf tendinopatisi , kalsifik tendinit , kısıtlı eklem mobililitesi sayılabilir. Nöropatik artropati, DM kas infarktüsü , dizin osteoartriti alt ekstremite tutuluma bağlı görülen diyabete bağlı hastalıklardır. Omurga da ise diffüz ididaopatik hiperosteozis görülebilir. Osteoporozda diyabetik bireylerde kemik sistemini etkileyen önemli sağlık sorunudur.
SONUÇ: El veya omuz rahatsızlıklarının görülme sıklığı diyabetli hastalarda kontrollerden daha yüksektir ve diyabetin süresiyle ilişkilidir, ancak tipiyle ilişkili değildir. El anormallikleri yaygındır. Kırık riski, hem tip 1 hem de tip 2 diyabetli bireylerde, kemik mineral yoğunluğuna (KMY) ek olarak diyabet süresi, glisemik yönetim, diyabetle ilişkili komplikasyonlar, kemik kalitesi, tedavi ve düşme riski gibi faktörler nedeniyle artabilir.
INTRODUCTION: Diabetes mellitus (DM) is associated with numerous complications related to the musculoskeletal system and joints. In this section, the effects of diabetes on the musculoskeletal system are explained.
DEVELOPMENT: DM-related musculoskeletal diseases are grouped as diseases affecting the hand, shoulder, lower extremity and spine region. Carpal tunnel syndrome, dupuyturen contracture, flexor tenosynovitis, diabetic sclerodactyly, limited joint mobility are DM-related hand involvements. DM- related shoulder involvements include adhesive capsulitis, rotator cuff tendinopathy, calcific tendonitis, and limited joint mobility. Neuropathic arthropathy, DM muscle infarction, and knee osteoarthritis are diabetes-related diseases seen due to lower extremity involvement. Diffuse idiopathic hyperostosis can be seen in the spine. Osteoporosis is also an important health problem affecting the bone system in diabetic individuals.
CONCLUSION: The incidence of hand or shoulder disorders is higher in diabetic patients than in controls and is related to the duration of diabetes, but not to the type. Hand abnormalities are common. The risk of fracture may increase in individuals with both type 1 and type 2 diabetes due to factors such as duration of diabetes, glycemic management, diabetes-related complications, bone quality, treatment, and fall risk, in addition to bone mineral density (BMD).
Referanslar
American Diabetes Association Professional Practice Committee (2022). 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2022. Diabetes care, 45(Suppl 1), S17–S38. https://doi.org/10.2337/dc22-S002.
Standards of Medical Care in Diabetes-2017: Summary of Revisions. (2017). Diabetes care, 40(Suppl 1), S4–S5. https://doi.org/10.2337/dc17-S0.
Shih HM, Tsai WC, Wu PY at al. Risk of rapid progression to dialysis in patients with type 2 diabetes mellitus with and without diabetes-related complications at diagnosis. Sci Rep. 2023 Sep 29;13(1):16366. doi: 10.1038/s41598-023-43513-z. PMID: 37773429; PMCID: PMC10541444.
Kamei Y, Miura S, Suzuki M. et al. (2004). Skeletal muscle FOXO1 (FKHR) transgenic mice have less skeletal muscle mass, down-regulated Type I (slow twitch/red muscle) fiber genes, and impaired glycemic control. The Journal of biological chemistry, 279(39), 41114–41123. https://doi.org/10.1074/jbc.M400674200.
Oberbach A, Bossenz Y, Lehmann S, et al. (2006). Altered fiber distribution and fiber-specific glycolytic and oxidative enzyme activity in skeletal muscle of patients with type 2 diabetes. Diabetes care, 29(4), 895–900. https://doi.org/10.2337/diacare.29.04.06.dc05-1854.
Regensteiner JG, Sippel J, McFarling ET, Wolfel EE, Hiatt WR. Effects of non-insulin-dependent diabetes on oxygen consumption during treadmill exercise. Med Sci Sports Exerc. 1995;27(6):875-881.
Zyluk A, Puchalski P. Hand disorders associated with diabetes: a review. Acta Orthop Belg. 2015;81(2):191-196.
Ghasemi-Rad M, Nosair E, Vegh A, et al. (2014). A handy review of carpal tunnel syndrome: From anatomy to diagnosis and treatment. World journal of radiology, 6(6), 284–300. https://doi.org/10.4329/wjr.v6.i6.284 .
Chammas M, Bousquet P, Renard E, et al. (1995). Dupuytren's disease, carpal tunnel syndrome, trigger finger, and diabetes mellitus. The Journal of hand surgery, 20(1), 109–114. https://doi.org/10.1016/S0363-5023(05)80068-1.
Perkins BA, Olaleye D, Bril V. Carpal tunnel syndrome in patients with diabetic polyneuropathy. Diabetes Care. 2002;25(3):565-569. doi:10.2337/diacare.25.3.565.
Chammas M., Bousquet P, Renard E, et al. (1995). Dupuytren's disease, carpal tunnel syndrome, trigger finger, and diabetes mellitus. The Journal of hand surgery, 20(1), 109–114. https://doi.org/10.1016/S0363-5023(05)80068-1.
Comi G, Lozza L, Galardi G, et al.(1985). Presence of carpal tunnel syndrome in diabetics: effect of age, sex, diabetes duration and polyneuropathy. Acta diabetologica latina, 22(3), 259–262. https://doi.org/10.1007/BF02590778.
Gamstedt A, Holm-Glad J, Ohlson CG, et al. Hand abnormalities are strongly associated with the duration of diabetes mellitus. J Intern Med. 1993;234(2):189-193. doi:10.1111/j.1365-2796.1993.tb00729.x.
Stamboulis E, Voumvourakis K, Andrikopoulou A, et al. Association between asymptomatic median mononeuropathy and diabetic polyneuropathy severity in patients with diabetes mellitus. J Neurol Sci. 2009;278(1-2):41-43. doi:10.1016/j.jns.2008.11.006.
Burge P, Hoy G, Regan P, et al.Smoking, alcohol and the risk of Dupuytren's contracture. J Bone Joint Surg Br. 1997;79(2):206-210. doi:10.1302/0301-620x.79b2.6990.
Noble J, Heathcote JG, Cohen H. Diabetes mellitus in the aetiology of Dupuytren's disease. J Bone Joint Surg Br. 1984;66(3):322-325. doi:10.1302/0301-620X.66B3.6725338.
Erol K, Uğurlu H. Tip 2 Diyabetes Mellitus Tanılı Hastalarda El Komplikasyonları ve KlinikVerilerle İlişkisi. Aegean J Med Sci 2020; 2:67- 73.
Kirazlı Y. Diyabetik El Rehabilitasyonu. Journal of Physical Medicine & Rehabilitation Sciences, 2011:14, Özel Sayı; 7-11.
Yosipovitch G, Yosipovitch Z, Karp M, et al. Trigger finger in young patients with insulin dependent diabetes. J Rheumatol. 1990;17(7):951-952.
Vance MC, Tucker JJ, Harness NG. The association of hemoglobin A1c with the prevalence of stenosing flexor tenosynovitis. J Hand Surg Am. 2012;37(9):1765-1769. doi: 10.1016/j.jhsa.2012.06.007.
Stahl S, Kanter Y, Karnielli E. Outcome of trigger finger treatment in diabetes. J Diabetes Complications. 1997;11(5):287-290. doi:10.1016/s1056-8727(96)00076-1.
Jelinek JE. The skin in diabetes. Diabet Med. 1993;10(3):201-213. doi:10.1111/j.1464-5491.1993.tb00048.x.
Seibold JR. Digital sclerosis in children with insulin-dependent diabetes mellitus. Arthritis Rheum. 1982;25(11):1357-1361. doi:10.1002/art.1780251112.
Kapoor A, Sibbitt WL Jr. Contractures in diabetes mellitus: the syndrome of limited joint mobility. Semin Arthritis Rheum. 1989;18(3):168-180. doi:10.1016/0049-0172(89)90059-0.
Zuckerman JD, Rokito A. Frozen shoulder: a consensus definition. J Shoulder Elbow Surg. 2011;20(2):322-325. doi: 10.1016/j.jse.2010.07.008.
Huang YP, Fann CY, Chiu YH, et al. Association of diabetes mellitus with the risk of developing adhesive capsulitis of the shoulder: a longitudinal population-based followup study. Arthritis Care Res (Hoboken). 2013;65(7):1197-1202. doi:10.1002/acr.21938.
Teunis T, Lubberts B, Reilly BT, et al.A systematic review and pooled analysis of the prevalence of rotator cuff disease with increasing age. J Shoulder Elbow Surg. 2014;23(12):1913-1921. doi: 10.1016/j.jse.2014.08.001.
Adriaanse MC, Drewes HW, van der Heide I, et al. The impact of comorbid chronic conditions on quality of life in type 2 diabetes patients. Qual Life Res. 2016;25(1):175-182. doi:10.1007/s11136-015-1061-0.
Shen PC, Chang PC, Jou IM, et al. Hand tendinopathy risk factors in Taiwan: A population-based cohort study. Medicine (Baltimore). 2019;98(1): e13795. doi :10.1097/MD.0000000000013795.
Ramchurn N, Mashamba C, Leitch E, et al. Upper limb musculoskeletal abnormalities and poor metabolic control in diabetes. Eur J Intern Med. 2009;20(7):718-721. doi: 10.1016/j.ejim.2009.08.001.
Cagliero E, Apruzzese W, Perlmutter GS, Nathan DM. Musculoskeletal disorders of the hand and shoulder in patients with diabetes mellitus. Am J Med. 2002;112(6):487-490. doi:10.1016/s0002-9343(02)01045-8.
Holte KB, Juel NG, Brox JI, et al. Hand, shoulder and back stiffness in long-term type 1 diabetes; cross-sectional association with skin collagen advanced glycation end-products. The Dialong study. J Diabetes Complications. 2017;31(9):1408-1414. doi: 10.1016/j.jdiacomp.2017.06.007.
Brownlee M, Cerami A, Vlassara H. Advanced glycosylation end products in tissue and the biochemical basis of diabetic complications. N Engl J Med. 1988;318(20):1315-1321. doi:10.1056/NEJM198805193182007.
Chaudhuri KR, Davidson AR, Morris IM. Limited joint mobility and carpal tunnel syndrome in insulin-dependent diabetes. Br J Rheumatol. 1989;28(3):191-194. doi:10.1093/rheumatology/28.3.191
Sheu A, Greenfield JR, White CP, et al. Contributors to impaired bone health in type 2 diabetes. Trends Endocrinol Metab. 2023;34(1):34-48. doi: 10.1016/j.tem.2022.11.003.
Cipriani C, Colangelo L, Santori R, et al. The Interplay Between Bone and Glucose Metabolism. Front Endocrinol (Lausanne). 2020;11:122. Published 2020 Mar 24. doi:10.3389/fendo.2020.00122.
Losada-Grande E, Hawley S, Soldevila B, et al.(2017) Insulin use and excess fracture risk in patients with type 2 diabetes: a propensity-matched cohort analysis. Sci Rep 7(1):3781.
Iki M, Fujita Y, Kouda K, et al. Hyperglycemia is associated with increased bone mineral density and decreased trabecular bone score in elderly Japanese men: The Fujiwara-kyo osteoporosis risk in men (FORMEN) study. Bone. 2017;105:18-25. doi:10.1016/j.bone.2017.08.007.
Liu M, Lu Y, Cheng X, et al. Relationship between abnormal glucose metabolism and osteoporosis in Han Chinese men over the age of 50 years. Clin Interv Aging. 2019; 14:445-451. Published 2019 Feb 25. doi:10.2147/CIA.S164021.
Jang M, Kim H, Lea S, et al. Effect of duration of diabetes on bone mineral density: a population study on East Asian males. BMC Endocr Disord. 2018;18(1):61. Published 2018 Sep 5. doi:10.1186/s12902-018-0290-y.
Cui R, Zhou L, Li Z, et al. Assessment risk of osteoporosis in Chinese people: relationship among body mass index, serum lipid profiles, blood glucose, and bone mineral density. Clin Interv Aging. 2016; 11:887-895. Published 2016 Jul 4. doi:10.2147/CIA.S103845.
Ma L, Oei L, Jiang L, et al. Association between bone mineral density and type 2 diabetes mellitus: a meta-analysis of observational studies. Eur J Epidemiol. 2012;27(5):319-332. doi:10.1007/s10654-012-9674-x.
Referanslar
American Diabetes Association Professional Practice Committee (2022). 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2022. Diabetes care, 45(Suppl 1), S17–S38. https://doi.org/10.2337/dc22-S002.
Standards of Medical Care in Diabetes-2017: Summary of Revisions. (2017). Diabetes care, 40(Suppl 1), S4–S5. https://doi.org/10.2337/dc17-S0.
Shih HM, Tsai WC, Wu PY at al. Risk of rapid progression to dialysis in patients with type 2 diabetes mellitus with and without diabetes-related complications at diagnosis. Sci Rep. 2023 Sep 29;13(1):16366. doi: 10.1038/s41598-023-43513-z. PMID: 37773429; PMCID: PMC10541444.
Kamei Y, Miura S, Suzuki M. et al. (2004). Skeletal muscle FOXO1 (FKHR) transgenic mice have less skeletal muscle mass, down-regulated Type I (slow twitch/red muscle) fiber genes, and impaired glycemic control. The Journal of biological chemistry, 279(39), 41114–41123. https://doi.org/10.1074/jbc.M400674200.
Oberbach A, Bossenz Y, Lehmann S, et al. (2006). Altered fiber distribution and fiber-specific glycolytic and oxidative enzyme activity in skeletal muscle of patients with type 2 diabetes. Diabetes care, 29(4), 895–900. https://doi.org/10.2337/diacare.29.04.06.dc05-1854.
Regensteiner JG, Sippel J, McFarling ET, Wolfel EE, Hiatt WR. Effects of non-insulin-dependent diabetes on oxygen consumption during treadmill exercise. Med Sci Sports Exerc. 1995;27(6):875-881.
Zyluk A, Puchalski P. Hand disorders associated with diabetes: a review. Acta Orthop Belg. 2015;81(2):191-196.
Ghasemi-Rad M, Nosair E, Vegh A, et al. (2014). A handy review of carpal tunnel syndrome: From anatomy to diagnosis and treatment. World journal of radiology, 6(6), 284–300. https://doi.org/10.4329/wjr.v6.i6.284 .
Chammas M, Bousquet P, Renard E, et al. (1995). Dupuytren's disease, carpal tunnel syndrome, trigger finger, and diabetes mellitus. The Journal of hand surgery, 20(1), 109–114. https://doi.org/10.1016/S0363-5023(05)80068-1.
Perkins BA, Olaleye D, Bril V. Carpal tunnel syndrome in patients with diabetic polyneuropathy. Diabetes Care. 2002;25(3):565-569. doi:10.2337/diacare.25.3.565.
Chammas M., Bousquet P, Renard E, et al. (1995). Dupuytren's disease, carpal tunnel syndrome, trigger finger, and diabetes mellitus. The Journal of hand surgery, 20(1), 109–114. https://doi.org/10.1016/S0363-5023(05)80068-1.
Comi G, Lozza L, Galardi G, et al.(1985). Presence of carpal tunnel syndrome in diabetics: effect of age, sex, diabetes duration and polyneuropathy. Acta diabetologica latina, 22(3), 259–262. https://doi.org/10.1007/BF02590778.
Gamstedt A, Holm-Glad J, Ohlson CG, et al. Hand abnormalities are strongly associated with the duration of diabetes mellitus. J Intern Med. 1993;234(2):189-193. doi:10.1111/j.1365-2796.1993.tb00729.x.
Stamboulis E, Voumvourakis K, Andrikopoulou A, et al. Association between asymptomatic median mononeuropathy and diabetic polyneuropathy severity in patients with diabetes mellitus. J Neurol Sci. 2009;278(1-2):41-43. doi:10.1016/j.jns.2008.11.006.
Burge P, Hoy G, Regan P, et al.Smoking, alcohol and the risk of Dupuytren's contracture. J Bone Joint Surg Br. 1997;79(2):206-210. doi:10.1302/0301-620x.79b2.6990.
Noble J, Heathcote JG, Cohen H. Diabetes mellitus in the aetiology of Dupuytren's disease. J Bone Joint Surg Br. 1984;66(3):322-325. doi:10.1302/0301-620X.66B3.6725338.
Erol K, Uğurlu H. Tip 2 Diyabetes Mellitus Tanılı Hastalarda El Komplikasyonları ve KlinikVerilerle İlişkisi. Aegean J Med Sci 2020; 2:67- 73.
Kirazlı Y. Diyabetik El Rehabilitasyonu. Journal of Physical Medicine & Rehabilitation Sciences, 2011:14, Özel Sayı; 7-11.
Yosipovitch G, Yosipovitch Z, Karp M, et al. Trigger finger in young patients with insulin dependent diabetes. J Rheumatol. 1990;17(7):951-952.
Vance MC, Tucker JJ, Harness NG. The association of hemoglobin A1c with the prevalence of stenosing flexor tenosynovitis. J Hand Surg Am. 2012;37(9):1765-1769. doi: 10.1016/j.jhsa.2012.06.007.
Stahl S, Kanter Y, Karnielli E. Outcome of trigger finger treatment in diabetes. J Diabetes Complications. 1997;11(5):287-290. doi:10.1016/s1056-8727(96)00076-1.
Jelinek JE. The skin in diabetes. Diabet Med. 1993;10(3):201-213. doi:10.1111/j.1464-5491.1993.tb00048.x.
Seibold JR. Digital sclerosis in children with insulin-dependent diabetes mellitus. Arthritis Rheum. 1982;25(11):1357-1361. doi:10.1002/art.1780251112.
Kapoor A, Sibbitt WL Jr. Contractures in diabetes mellitus: the syndrome of limited joint mobility. Semin Arthritis Rheum. 1989;18(3):168-180. doi:10.1016/0049-0172(89)90059-0.
Zuckerman JD, Rokito A. Frozen shoulder: a consensus definition. J Shoulder Elbow Surg. 2011;20(2):322-325. doi: 10.1016/j.jse.2010.07.008.
Huang YP, Fann CY, Chiu YH, et al. Association of diabetes mellitus with the risk of developing adhesive capsulitis of the shoulder: a longitudinal population-based followup study. Arthritis Care Res (Hoboken). 2013;65(7):1197-1202. doi:10.1002/acr.21938.
Teunis T, Lubberts B, Reilly BT, et al.A systematic review and pooled analysis of the prevalence of rotator cuff disease with increasing age. J Shoulder Elbow Surg. 2014;23(12):1913-1921. doi: 10.1016/j.jse.2014.08.001.
Adriaanse MC, Drewes HW, van der Heide I, et al. The impact of comorbid chronic conditions on quality of life in type 2 diabetes patients. Qual Life Res. 2016;25(1):175-182. doi:10.1007/s11136-015-1061-0.
Shen PC, Chang PC, Jou IM, et al. Hand tendinopathy risk factors in Taiwan: A population-based cohort study. Medicine (Baltimore). 2019;98(1): e13795. doi :10.1097/MD.0000000000013795.
Ramchurn N, Mashamba C, Leitch E, et al. Upper limb musculoskeletal abnormalities and poor metabolic control in diabetes. Eur J Intern Med. 2009;20(7):718-721. doi: 10.1016/j.ejim.2009.08.001.
Cagliero E, Apruzzese W, Perlmutter GS, Nathan DM. Musculoskeletal disorders of the hand and shoulder in patients with diabetes mellitus. Am J Med. 2002;112(6):487-490. doi:10.1016/s0002-9343(02)01045-8.
Holte KB, Juel NG, Brox JI, et al. Hand, shoulder and back stiffness in long-term type 1 diabetes; cross-sectional association with skin collagen advanced glycation end-products. The Dialong study. J Diabetes Complications. 2017;31(9):1408-1414. doi: 10.1016/j.jdiacomp.2017.06.007.
Brownlee M, Cerami A, Vlassara H. Advanced glycosylation end products in tissue and the biochemical basis of diabetic complications. N Engl J Med. 1988;318(20):1315-1321. doi:10.1056/NEJM198805193182007.
Chaudhuri KR, Davidson AR, Morris IM. Limited joint mobility and carpal tunnel syndrome in insulin-dependent diabetes. Br J Rheumatol. 1989;28(3):191-194. doi:10.1093/rheumatology/28.3.191
Sheu A, Greenfield JR, White CP, et al. Contributors to impaired bone health in type 2 diabetes. Trends Endocrinol Metab. 2023;34(1):34-48. doi: 10.1016/j.tem.2022.11.003.
Cipriani C, Colangelo L, Santori R, et al. The Interplay Between Bone and Glucose Metabolism. Front Endocrinol (Lausanne). 2020;11:122. Published 2020 Mar 24. doi:10.3389/fendo.2020.00122.
Losada-Grande E, Hawley S, Soldevila B, et al.(2017) Insulin use and excess fracture risk in patients with type 2 diabetes: a propensity-matched cohort analysis. Sci Rep 7(1):3781.
Iki M, Fujita Y, Kouda K, et al. Hyperglycemia is associated with increased bone mineral density and decreased trabecular bone score in elderly Japanese men: The Fujiwara-kyo osteoporosis risk in men (FORMEN) study. Bone. 2017;105:18-25. doi:10.1016/j.bone.2017.08.007.
Liu M, Lu Y, Cheng X, et al. Relationship between abnormal glucose metabolism and osteoporosis in Han Chinese men over the age of 50 years. Clin Interv Aging. 2019; 14:445-451. Published 2019 Feb 25. doi:10.2147/CIA.S164021.
Jang M, Kim H, Lea S, et al. Effect of duration of diabetes on bone mineral density: a population study on East Asian males. BMC Endocr Disord. 2018;18(1):61. Published 2018 Sep 5. doi:10.1186/s12902-018-0290-y.
Cui R, Zhou L, Li Z, et al. Assessment risk of osteoporosis in Chinese people: relationship among body mass index, serum lipid profiles, blood glucose, and bone mineral density. Clin Interv Aging. 2016; 11:887-895. Published 2016 Jul 4. doi:10.2147/CIA.S103845.
Ma L, Oei L, Jiang L, et al. Association between bone mineral density and type 2 diabetes mellitus: a meta-analysis of observational studies. Eur J Epidemiol. 2012;27(5):319-332. doi:10.1007/s10654-012-9674-x.
