Konya ilinde geriatrik yaş grubunda sarkopeni sıklığı çalışması
Yükleniyor...
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Sarkopeni özellikle yaşlı nüfusta görülen düşme, günlük yaşam fonksiyonlarını yerine getirmede zorlanma, kırılganlık ve mortalite gibi kötü sonuçlarla ilişkili geriatrik bir sendromdur. Özellikle kas kütlesi kaybı, kas gücü kaybı ve fonksiyonel kapasitede azalma ile ortaya çıkar. Yaşlı nüfusun giderek artması sarkopeninin de giderek önemli bir halk sağlığı sorunu olmasına neden olmaktadır.
Çalışmamızda geriatrik yaş grubunda sarkopeni sıklığınının belirlenmesini, sarkopeninin günlük pratikte kullanılan laboratuvar değerleriyle, ek hastalıklarla ilişkisini belirlemeyi amaçladık. Yöntem: Kasım 2022 ile Haziran 2023 arasında Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi İç Hastalıkları Kliniğine başvurmuş olan 65 yaş üzerinde toplam 40 hasta dahil edildi. Çalışmamıza sağlıklı kontrol grubu dahil edilmemiştir. Bu çalışmaya ileri derecede kalp yetmezliği, ileri derecede KOAH, geçirilmiş SVO, malignite tanısı olan hastalar dahil edilmedi. Hastaların demografik verileri, takipli olduğu kronik hastalıkları, kullandığı medikal tedaviler kaydedildi. 65 yaş üstü yaş grubunda rutin olarak görülen ve takibi yapılan hemoglobin, glukoz, albümin, lipit paneli, kreatin, üre, TSH, kalsiyum, fosfor, alkalen fosfataz, B12 ve D vitamini düzeyleri kaydedildi. Hastaların antropometrik ölçümleri açısından boy ve kilo ölçümleri yapıldı. Vücut ağırlığının boy uzunluğunun karesine bölünmesi (kg/m²) ile vücut kitle indeksi (BMI) hesaplandı. Tüm hastaların kas kütlesi ve kemik mineral yoğunluklarının tespiti açısından Necmettin Erbakan üniversitesi Meram Tıp fakültesinde bulunan PRIMUS DEXA cihazıyla ölçüm yapıldı. Hastaların kas gücü ölçümleri Hand Held Dinamometre ile yapıldı. Çalışmaya alınan hastaların fonksiyonel kapasitelerinin değerlendirilmesi açısından hastalara 6 dk yürüme testi uygulandı. Bulgular: Çalışmaya katılan tüm hastaların yaş ortalaması 68,00 (67,00-71,50) görüldü. Hastaların %77,5’ i (n=31) kadındı. Hastaların BMI ortalaması 29,41 ± 4,279 tespit edildi. En çok eşlik eden ek hastalık %77,5 ile (n=31) hipertansiyondu. Çalışmamızda sarkopeni kriterleri kullanılarak yapılan incelemede hastaların %60’ ında (n=24) sarkopeni olduğu tespit edildi. Sarkopenisi olan grupta BMI anlamlı yüksek bulundu. (p=0,014) Yapılan bu karşılaştırmada yine sarkopenisi olan grupta fosfor da anlamlı şekilde yüksek bulundu.
v
Toplam kemik mineral indeksleri (KMI) değerleri sarkopenik olanlarda düşük izlendi. Sarkopenik grupta kas hacminin (kas kütlesi) toplam kiloya oranı anlamlı şekilde düşük bulundu. (p=0.001) Kadınlarda erkeklere göre daha fazla sarkopeni görüldü. (p=0,000) Osteoporozu olanlar ve olmayanlar karşılaştırıldığında osteoporoz tanısı olan grupta sarkopeni görülme olasılığı anlamlı olarak yüksek görüldü. (p=0,064) Sarkopenisi olan gruplarda D vitamini, B12 vitamini düşüklüğünün ve aneminin prognozu kötüleştirdiği gösterildi. Hasta yaşı, BMI, albümin, kreatinin, üre, fosfor, vitamin D, ALP, B12, lomber ve femur boyun T skorları gibi sarkopeniyi etkilemesi beklenen değerler kullanılarak sarkopeniyi etkileyip etkilemediğinin ya da ne kadar etkilediğinin değerlendirilmesi için çok değişkenli doğrusal regresyon analizi yapıldı. Beta=0.702, t(19) = 3.34, p=0.003, pr2 = 0.37 . T skorunun 1 kat artışı sarkopeniyi 0.7 kat artırmakta görüldü.
Sonuç: Sarkopeni öncelikle yaşlılıkla birlikte ortaya çıkan, birçok faktörden etkilenen, kötü sonuçlarla ilişkili, önemi giderek artan bir sağlık sorunudur. Bu sağlık sorununun tanınması, riskli popülasyonda uygun yöntemler kullanılarak tarama yapılması sarkopeninin yol açtığı morbidite ve mortalitenin engellenmesinde önemli yere sahiptir.
Objective: Sarcopenia is a geriatric syndrome that is especially seen in the elderly population and is associated with poor outcomes such as falls, difficulty in performing daily life functions, frailty and mortality. It occurs especially with loss of muscle mass, loss of muscle strength and decrease in functional capacity. The increasing elderly population causes sarcopenia to become an increasingly important public health problem. In our study, we aimed to determine the frequency of sarcopenia in the geriatric age group and to determine the relationship of sarcopenia with laboratory values used in daily practice and additional diseases. Method: A total of 40 patients over the age of 65 who applied to Necmettin Erbakan University Meram Medical Faculty Internal Medicine Clinic between November 2022 and June 2023 were included. A healthy control group was not included in our study. Patients with advanced heart failure, advanced chronic obstructive pulmonary disease, previous cerebrovascular disease, and patients diagnosed with malignancy were not included in this study. Demographic data, chronic diseases and medical treatments used by the patients were recorded. In the over 65 age group, hemoglobin, glucose, albumin, lipid panel, creatinine, urea, TSH, calcium, phosphorus, alkaline phosphatase, vitamin B12 and vitamin D levels were recorded. Height and weight measurements were taken for the patients' anthropometric measurements. Body mass index (BMI) was calculated by dividing body weight by the square of height (kg/m²). In order to determine the muscle mass and bone mineral density of all patients, measurements were made with the PRIMUS DEXA device located at Necmettin Erbakan University, Meram Medical Faculty. Muscle strength measurements of the patients were made with a Hand Held Dynamometer. In order to evaluate the functional capacities of the patients included in the study, a 6-minute walking test was applied to the patients. Results: The average age of all patients participating in the study was 68.00 (67.00-71.50). 77.5% (n=31) of the patients were women. The average BMI of the patients was determined as 29.41 ± 4.279. The most common comorbid disease was hypertension with 77.5% (n=31). In our study, the analysis using sarcopenia criteria revealed that 60% of the patients (n=24) vii had sarcopenia. BMI was found to be significantly higher in the sarcopenia group. (p=0.014) In this comparison, phosphorus was also found to be significantly higher in the sarcopenia group. Total bone mineral index values were observed to be low in sarcopenic patients. The ratio of muscle volume (muscle mass) to total weight was found to be significantly lower in the sarcopenic group. (p=0.001) Sarcopenia was seen more in women than in men. (p=0.000) When those with and without osteoporosis were compared, the probability of sarcopenia was found to be significantly higher in the group diagnosed with osteoporosis. (p=0.064) It was shown that low levels of vitamin D, vitamin B12 and anemia worsened the prognosis in groups with sarcopenia. Multivariate linear regression analysis was performed to evaluate whether and how much it affected sarcopenia, using values expected to affect sarcopenia, such as patient age, BMI, albumin, creatinine, urea, phosphorus, vitamin D, ALP, B12, lumbar and femoral neck T scores. Beta=0.702, t(19) = 3.34, p=0.003, pr2 = 0.37. A 1-fold increase in the T score was observed to increase sarcopenia by 0.7 times. Conclusion: Sarcopenia is an increasingly important health problem that occurs primarily with old age, is affected by many factors, and is associated with poor outcomes. Recognizing this health problem and screening the risky population using appropriate methods have an important place in preventing the morbidity and mortality caused by sarcopenia.
Objective: Sarcopenia is a geriatric syndrome that is especially seen in the elderly population and is associated with poor outcomes such as falls, difficulty in performing daily life functions, frailty and mortality. It occurs especially with loss of muscle mass, loss of muscle strength and decrease in functional capacity. The increasing elderly population causes sarcopenia to become an increasingly important public health problem. In our study, we aimed to determine the frequency of sarcopenia in the geriatric age group and to determine the relationship of sarcopenia with laboratory values used in daily practice and additional diseases. Method: A total of 40 patients over the age of 65 who applied to Necmettin Erbakan University Meram Medical Faculty Internal Medicine Clinic between November 2022 and June 2023 were included. A healthy control group was not included in our study. Patients with advanced heart failure, advanced chronic obstructive pulmonary disease, previous cerebrovascular disease, and patients diagnosed with malignancy were not included in this study. Demographic data, chronic diseases and medical treatments used by the patients were recorded. In the over 65 age group, hemoglobin, glucose, albumin, lipid panel, creatinine, urea, TSH, calcium, phosphorus, alkaline phosphatase, vitamin B12 and vitamin D levels were recorded. Height and weight measurements were taken for the patients' anthropometric measurements. Body mass index (BMI) was calculated by dividing body weight by the square of height (kg/m²). In order to determine the muscle mass and bone mineral density of all patients, measurements were made with the PRIMUS DEXA device located at Necmettin Erbakan University, Meram Medical Faculty. Muscle strength measurements of the patients were made with a Hand Held Dynamometer. In order to evaluate the functional capacities of the patients included in the study, a 6-minute walking test was applied to the patients. Results: The average age of all patients participating in the study was 68.00 (67.00-71.50). 77.5% (n=31) of the patients were women. The average BMI of the patients was determined as 29.41 ± 4.279. The most common comorbid disease was hypertension with 77.5% (n=31). In our study, the analysis using sarcopenia criteria revealed that 60% of the patients (n=24) vii had sarcopenia. BMI was found to be significantly higher in the sarcopenia group. (p=0.014) In this comparison, phosphorus was also found to be significantly higher in the sarcopenia group. Total bone mineral index values were observed to be low in sarcopenic patients. The ratio of muscle volume (muscle mass) to total weight was found to be significantly lower in the sarcopenic group. (p=0.001) Sarcopenia was seen more in women than in men. (p=0.000) When those with and without osteoporosis were compared, the probability of sarcopenia was found to be significantly higher in the group diagnosed with osteoporosis. (p=0.064) It was shown that low levels of vitamin D, vitamin B12 and anemia worsened the prognosis in groups with sarcopenia. Multivariate linear regression analysis was performed to evaluate whether and how much it affected sarcopenia, using values expected to affect sarcopenia, such as patient age, BMI, albumin, creatinine, urea, phosphorus, vitamin D, ALP, B12, lumbar and femoral neck T scores. Beta=0.702, t(19) = 3.34, p=0.003, pr2 = 0.37. A 1-fold increase in the T score was observed to increase sarcopenia by 0.7 times. Conclusion: Sarcopenia is an increasingly important health problem that occurs primarily with old age, is affected by many factors, and is associated with poor outcomes. Recognizing this health problem and screening the risky population using appropriate methods have an important place in preventing the morbidity and mortality caused by sarcopenia.
Açıklama
Anahtar Kelimeler
Sarkopeni, Kas gücü, Kas kütlesi, Fonsiyonel kapasite, Yaşlı, DEXA, Sarcopenia, Muscle strength, Muscle mass, Functional capacity, Elderly, DEXA
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Kumru, B. G. (2023). Konya ilinde geriatrik yaş grubunda sarkopeni sıklığı çalışması. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü İç Hastalıkları Anabilim Dalı, Konya.
