<p>UVOD: Artroza šaka predstavlja jednu od najčešćih mišićno-skeletnih bolesti. Manifestuje se bolom, nekada otokom, deformacijom i gubitkom funkcije šaka. Postoje različita mišljenja o povezanosti osteoartroze (OA) i osteoporoze (OP) kao dva najčeša skeletna poremećaja. CILJ: istraživanja je da se utvrde faktori rizika za nastanak OA šaka, uporedi mineralna koštana gustina kod pacijenata sa OA šaka sa kontrolnom grupom i utvrdi značaj metaboličkog sindroma kod pacijenata sa OA šaka. MATERIJAL I METODE: Istraživanje je obavljeno u periodu od jedne godine kod bolesnika sa OA šaka – eksperimentalna grupa, i u kontrolnoj grupi bez OA. OA šaka je definisana na osnovu bola, klinički prisutnih deformiteta šaka kod žena u postmenopauzi starosne dobi od 60-70 godina i radiografskih promena ( drugog do četvrtog stepena prema Kellgren-Lowrencovoj skali). Analizirani su faktori rizika odgovorni za nastanak OA šaka, povezanost OA šaka sa snagom stiska šake, mineralnom koštanom gustinom i metaboličkim sindromom. Analazirirana je i funkcija šake pomoću tri validirana upitnika: Michigan Hand Outcomes Questionnaire (MHQ, Duruoz Hand Indeks (DHI), Health Assessment Questionnaire (PROMIS HAQ). Statistička obrada podataka rađena je u programu SPSS verzija 25. REZULTATI: Prosečna starost pacijentkinja je bila 65,89±3,67 godina. Eksperimentalna i kontrola grupa se statistički razlikuju prema porodičnoj anamnezi o strukturnim promenama zglobova šaka, prema bolnosti šaka u miru, bolnosti šaka pri palpaciji, uzdržavanju od pokreta prstiju šaka, snage stiska šake, metaboličkom sindromu( p<0,001). Kao značajni prediktori za nastanak osteoartroze šaka su se izdvojili pozitivna porodična anamneza o strukturnim promenama za zglobovima šaka i metabolički sindrom ( p<0,001). Utvrđen je veći broj ispitanica sa normalnom koštanom gustinom u kontrolnoj grupi. Eksperimentalna grupa bolesnica imala je lošiju funkciju šake, odnosno lošiji skor primenom validiranih upitnika ( p <0,001). ZAKLJUČAK: Pacijentkinje sa izraženom osteoartrozom šaka imaju smanjenu funkciju šake, češći metabolički sindrom u odnosu na kontrolnu grupu, ali ne i značajno nižu koštanu gustinu.</p> / <p>INTRODUCTION: Arthritis of the hand is one of the most common musculoskeletal disorders. It manifests as pain, sometimes accompanied by swelling and deformities, which may lead to the loss of hand function. However, there is no consensus on the relationship between osteoarthritis (OA) and osteoporosis (OP) as the two most common skeletal disorders. AIMS: The study aim was to determine the risk factors related to the development of OA in the hand, as well as compare the bone density in patients with hand OA (HOA) with that measured in the control group and establish the significance of metabolic syndrome in the HOA group. MATERIAL AND METHODS: The study was conducted over a 12-month period and included a sample comprising of the experimental (patients affected by HOA) and the control (individuals with no evidence of HOA) group. HOA was diagnosed based on the reported pain, clinical evidence of hand deformities in postmenopausal women aged 60−70, and radiological evidence of physiological changes (Grade II to IV, based on the Kellgren-Lowrence scale). The risk factors for the development of HOA were analyzed, along with the link between HOA and hand grip strength, bone mineral density and metabolic syndrome. Analyses also included had function, as determined by three validated questionnaires: Michigan Hand Outcomes Questionnaire (MHQ), Duruoz Hand Index (DHI), and Health Assessment Questionnaire (PROMIS HAQ). Statistical analyses were performed using the SPSS version 25 computer software. RESULTS: The average age of the sample was 65.89±3.67 years. There were statically significant differences between the experimental and the control group with respect to the family history of structural changes in the hand joints, perceived hand pain at rest and when palpated, reluctance to utilize fingers, hand grip strength, and metabolic syndrome (p < 0.001). Family history of structural changes to the hand joints and metabolic syndrome emerged as the strongest predictors of the osteoarthritis of the hand development (p < 0.001). A greater number of the control group members had normal bone mineral density, while the patients assigned to the experimental group had inferior hand function, as determined by the score on the aforementioned validated questionnaires (p < 0.001). CONCLUSION: Postmenopausal women with pronounced osteoarthritis of the hand have reduced hand function, and are more likely to suffer from a metabolic syndrome relative to the control group, while the differences in bone mineral density are not statistically significant.</p>
| Identifer | oai:union.ndltd.org:uns.ac.rs/oai:CRISUNS:(BISIS)109650 |
| Date | 11 March 2019 |
| Creators | Zvekić-Svorcan Jelena |
| Contributors | Mikov Aleksandra, Stamenković Bojana, Tomašević-Todorović Snežana, Tomić Lučić Aleksandra, Krasnik Rastislava |
| Publisher | Univerzitet u Novom Sadu, Medicinski fakultet u Novom Sadu, University of Novi Sad, Faculty of Medicine at Novi Sad |
| Source Sets | University of Novi Sad |
| Language | Serbian |
| Detected Language | English |
| Type | PhD thesis |
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