Psöriatik artritli olgularda metabolik sendrom varlığının uyku kalitesi üzerine etkisinin araştırılması
Investigation of the impact of metabolic syndrome presence on sleep quali̇ty in pati̇ents with psori̇ati̇c arthritis
- Tez No: 840937
- Danışmanlar: PROF. DR. TİMUR PIRILDAR
- Tez Türü: Tıpta Uzmanlık
- Konular: Romatoloji, İç Hastalıkları, Rheumatology, Internal diseases
- Anahtar Kelimeler: Belirtilmemiş.
- Yıl: 2023
- Dil: Türkçe
- Üniversite: Manisa Celal Bayar Üniversitesi
- Enstitü: Tıp Fakültesi
- Ana Bilim Dalı: İç Hastalıkları Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: 98
Özet
AMAÇ: Araştırmanın amacı psöriyatik artrit olgularında metabolik sendrom ve uyku kalitesi arasındaki ilişkinin incelenmesidir. GEREÇ VE YÖNTEM: Araştırma kesitsel bir çalışmadır. Çalışma Manisa Celal Bayar Üniversitesi Tıp Fakültesi Hastanesi Romatoloji Polikliniği ve Romatoloji Servisinde yürütülmüştür. Olgulara poliklinik muayenelerinde ya da servis yatışlarında yüz yüze anket uygulanmıştır. Olguların primer doktoru tarafından uygulanan klinik muayene ve ölçümler kaydedilmiştir. Olgulara uygulanacak veri toplama formunda sosyodemografik veriler, hastalıkla ilgili veriler, PUKİ, NCEP ATP III kriterleri yer almaktadır. Toplam 94 Psöriatrik artrit hastası çalışmaya dahil edilmiştir. Çalışmanın sosyodemografik değişkenleri cinsiyet, yaş, medeni durum, eğitim, BKİ'dir. Hastalıkla ilişkili değişkenler hastalık başlangıç yaşı, hastalık süresi, tedavi durumu, Psöriazis bölge şiddet indeksi, PsA alt tipi, üveit varlığı, inflamatuvar barsak hastalığı, daktilit, tırnak tutulumu, CRP ve ESH değerleridir. Çalışmanın bağımlı değişkeni Pittsburgh Uyku Kalite İndeksi ve indekse ait puanlamalardır. Sayısal değişkenlerin normal dağıldığı bulunduğunda değişkenlerin 2 grupta karşılaştırılmasında student-t testi kullanılmıştır. Normal dağılıma uymayan sürekli değişkenler için 2 grup karşılaştırılmasında Mann-Whitney U testi kullanılmıştır. Nominal değişkenlerin karşılaştırılmasında Ki-kare testi kullanılmıştır, gözlerde 5'ten küçük değerlerin varlığında Fisher'ın kesin testi kullanılmıştır. Analizlerde SPSS 26.0 (IBM Corporation, Armonk, New York, United States) paket programı kullanılmıştır. İstatistiksel anlamlılık seviyesi p
Özet (Çeviri)
AIM: This cross-sectional study aimed to investigate the relationship between metabolic syndrome and sleep quality in psoriatic arthritis (PsA) patients. MATERIALS AND METHODS: The study was conducted at the Manisa Celal Bayar University Faculty of Medicine Hospital, specifically in the Rheumatology Outpatient Clinic and Rheumatology Service. Face-to-face surveys were administered to participants during outpatient clinic visits or inpatient stays. Clinical examinations and measurements conducted by the primary physicians were recorded. The data collection form included sociodemographic information, disease-related data, Pittsburgh Sleep Quality Index (PSQI), and NCEP ATP III criteria. A total of 94 PsA patients were included in the study. Sociodemographic variables such as gender, age, marital status, education, and body mass index (BMI) were considered. Disease-related variables included age of onset, disease duration, treatment status, Psoriasis Area and Severity Index (PASI) score, PsA subtype, presence of uveitis, inflammatory bowel disease, dactylitis, nail involvement, and CRP and ESR values. The dependent variable of the study was the Pittsburgh Sleep Quality Index and its scores. Student's t-test was used for comparing normally distributed numerical variables between two groups. The Mann-Whitney U test was employed for continuous variables that did not follow a normal distribution. The Chi-square test was used for the comparison of nominal variables, with Fisher's exact test used when values were less than 5. Statistical analysis was performed using SPSS 26.0, with a significance level set at p < 0.05. RESULTS: The mean age of the participants was determined to be 48.3±12.4 years. Of the participants, 35.1% were male, and 64.9% were female. Regarding marital status, 87.2% were married, 8.5% were single, and 4.3% were divorced. While 87.2% of the participants were illiterate, 23.4% were university graduates. The BMI values were measured as 28.6±5.5. The average age of onset of PsA in the study group was 42.4±12.8 years, with an average disease duration of 6.0±5.6 years. Among these cases, 36.2% used corticosteroids, 93.6% used nonsteroidal drugs, 5.3% used hydroxychloroquine, 43.6% used sulfasalazine, 77.7% used methotrexate, and 24.5% used leflunomide. Furthermore, 47.9% of the cases received biologic therapy. The mean ESR values were 35.5±22.7, and the mean CRP values were 2.4±8.9. PsA cases had asymmetric oligoarticular involvement in 33%, distal interphalangeal involvement in 25.5%, arthritis mutilans in 2.1%, symmetrical rheumatoid arthritis-like involvement in 52.1%, and axial involvement in 20.2%. The occurrence rate of uveitis was 9.6%, inflammatory bowel disease 2.1%, dactylitis 41.5%, and nail involvement 78.7%. The prevalence of metabolic syndrome was 35.1%. When examining the components of metabolic syndrome, abdominal obesity was present in 68.1%, hypertension in 30.9%, hypertriglyceridemia in 30.9%, low HDL in 31.9%, and high fasting blood sugar in 34.0%. Female participants were found to have a higher prevalence of poor sleep quality (p=0.014). The use of methotrexate was significantly higher in those with good sleep quality (p=0.005). Pittsburgh sleep disorder scores were significantly higher in cases with metabolic syndrome compared to those without (p=0.045). Similarly, Pittsburgh habitual sleep efficiency scores were significantly higher in cases with metabolic syndrome compared to those without (p=0.016). CONCLUSIONS: In our study, it was found that the components of metabolic syndrome did not have a direct impact on sleep quality. Only Pittsburgh habitual sleep efficiency and Pittsburgh sleep disorder scores were significantly higher in individuals with metabolic syndrome compared to PsA patients without metabolic syndrome. This suggests that metabolic syndrome in psoriatic arthritis patients may influence sleep quality. This finding emphasizes the need for closer examination of the sleep patterns of individuals with metabolic syndrome. Our study's contribution to the literature is revealing that psoriatic arthritis cases have a significant impact not only on joint health but also on important factors affecting quality of life. Therefore, it is concluded that focusing only on physical symptoms in the management of PsA is insufficient, and comorbidities should also be taken into account. It should be noted that metabolic syndrome and sleep problems affect the quality of life of patients and can influence treatment choices. Consequently, comprehensive evaluation and management of PsA cases require adopting multidisciplinary approaches. This can effectively intervene in both the musculoskeletal symptoms of the disease and potential comorbidities, positively impacting the quality of life and overall health of patients. KEY WORDS: Psoriatic Arthritis, Metabolic Syndrome, Sleep
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