Romatoid artritte hastalık aktivite indekslerinin mevsimsel duyarlılığı
Küçük Resim Yok
Tarih
2017
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
ÖZET Romatoid artrit (RA); başlıca sinovyal eklemlerin inflamasyonuyla karakterize kronik, progresif, otoimmun bir hastalıktır. Romatoid artritte progresyonun ve tedavinin etkinliğinin takibinde hastalık aktivitesinin değerlendirilmesi çok önemlidir. Bu çalışmanın asıl amacı, romatoid artritte hastalık aktivite indekslerinin mevsimsel duyarlılığını değerlendirmektir. Ayrıca romatoid artritte hastalık aktivitesinde mevsimsel değişimin varlığını ve bu değişimin Vitamin D düzeyleri ile ilişkisini sorguladık. Çalışmaya prospektif, tanı süresi 5 yıl ve üzerinde olan 118 romatoid artrit tanılı hasta ile ilkbahar mevsiminde başlandı, çalışma kış mevsiminde 85 hasta ile tamamlandı. Hastalar her mevsimde birer kez değerlendirildi. Hastalık aktivasyonu DAS28-ESR, DAS28-CRP, SDAI ve CDAI ölçekleri ile fonksiyonel durum HAQ anketi ile, yaşam kalitesi SF36 ile, depresyon varlığı BDÖ ile değerlendirildi. Ayrıca her mevsimde serum 25 (OH) Vitamin D düzeylerine bakıldı. Çalışma sonucunda romatoid artritte hastalık aktivitesinde mevsimsel dalgalanma olduğu saptandı. DAS28-ESR ve DAS28-CRP skor ortalamalarının sonbahar ve kış mevsimlerinde daha yüksek olduğu gözlendi. Hastalık aktivasyon parametrelerinden ESR, CRP ve şiş eklem sayısında da mevsimsel değişim olduğu saptandı; fakat SDAI ve CDAI skor ortalamalarında ise mevsimsel değişim gözlenmedi. Bütün mevsimlerde bütün hastalık aktivite indeksleri hem birbirleriyle hem de HAQ skoru ile ilişkili idi. Serum 25 (OH) Vitamin D düzeyleri ile hiçbir hastalık aktivite indeksinin mevsimsel değişimi ilişkili bulunmadı. Çalışmamız romatoid artritte mevsimsel değişimin varlığını birkaç hastalık aktivite indeksini kullanarak araştırması ve bu indekslerin mevsimsel değişim 79 duyarlılığını karşılaştırma yönleri ile literatürde ilk olma özelliği taşımaktadır. Çalışmamızın ileride bu konuda yapılacak olan detaylı çalışmalara temel olacağı düşüncesindeyiz. Anahtar Kelimeler: Romatoid artrit, DAS28, SDAI, CDAI, mevsimsel değişim
SEASONAL SENSITIVITIES OF THE DISEASE ACTIVITY INDICES FOR RHEUMATOID ARTHRITIS SUMMARY Rheumatoid arthritis (RA) is a chronic and progressive autoimmune disease which is primarily characterized by the inflammation of synovial joints. In rheumatoid arthritis, evaluation of the disease activity is very important in monitoring the disease progression and effectiveness of the treatment. The main purpose of this study was to evaluate the seasonal sensitivities of the disease activity indices in rheumatoid arthritis. We also evaluated the seasonal variations in the disease activity and questioned the association between these variations and the Vitamin D levels. This prospective study was commenced in the spring season with a total of 118 rheumatoid arthritis patients with a diagnosis of older than 5 years and was completed in winter with 85 patients. Each patient was evaluated once in every season. DAS28-ESR, DAS28-CRP, SDAI and CDAI scales were used to assess the disease activation, HAQ questionnaire was used to assess the functional status, SF36 was recruited for the assessment of life quality, and the presence of depression was evaluated with BDI. Serum 25-(OH) Vitamin D levels were measured in every season. The presence of seasonal fluctuations in the disease activity of rheumatoid arthritis was detected according to the results of this study. Among the parameters of disease activation ESR, CRP and the number of swollen joints were also detected to be subject to seasonal fluctuations, whereas the average SDAI and CDAI scores did not show any seasonal variations. Either of the disease activity indices was also correlated not only with each other but also with the HAQ scores in all seasons. Serum 25-(OH) Vitamin 81 D levels were not correlated with any fluctuation patterns of any disease activation indices. Our study was the first to evaluate the seasonal fluctuations in rheumatoid arthritis using several disease activity indices and to compare the seasonal sensitivities of the individual indices. We believe that our work will be a basis for more detailed studies in the future. Keywords: Rheumatoid arthritis, DAS28, SDAI, CDAI, seasonal variations
SEASONAL SENSITIVITIES OF THE DISEASE ACTIVITY INDICES FOR RHEUMATOID ARTHRITIS SUMMARY Rheumatoid arthritis (RA) is a chronic and progressive autoimmune disease which is primarily characterized by the inflammation of synovial joints. In rheumatoid arthritis, evaluation of the disease activity is very important in monitoring the disease progression and effectiveness of the treatment. The main purpose of this study was to evaluate the seasonal sensitivities of the disease activity indices in rheumatoid arthritis. We also evaluated the seasonal variations in the disease activity and questioned the association between these variations and the Vitamin D levels. This prospective study was commenced in the spring season with a total of 118 rheumatoid arthritis patients with a diagnosis of older than 5 years and was completed in winter with 85 patients. Each patient was evaluated once in every season. DAS28-ESR, DAS28-CRP, SDAI and CDAI scales were used to assess the disease activation, HAQ questionnaire was used to assess the functional status, SF36 was recruited for the assessment of life quality, and the presence of depression was evaluated with BDI. Serum 25-(OH) Vitamin D levels were measured in every season. The presence of seasonal fluctuations in the disease activity of rheumatoid arthritis was detected according to the results of this study. Among the parameters of disease activation ESR, CRP and the number of swollen joints were also detected to be subject to seasonal fluctuations, whereas the average SDAI and CDAI scores did not show any seasonal variations. Either of the disease activity indices was also correlated not only with each other but also with the HAQ scores in all seasons. Serum 25-(OH) Vitamin 81 D levels were not correlated with any fluctuation patterns of any disease activation indices. Our study was the first to evaluate the seasonal fluctuations in rheumatoid arthritis using several disease activity indices and to compare the seasonal sensitivities of the individual indices. We believe that our work will be a basis for more detailed studies in the future. Keywords: Rheumatoid arthritis, DAS28, SDAI, CDAI, seasonal variations
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Fiziksel Tıp ve Rehabilitasyon, Physical Medicine and Rehabilitation
