Ray Subhabrata, Datta Ananta Kr, Sinhamahapatra Pradyot, Ray Indranil, Mukhopadhyay Pradip, Dasgupta Somnath
Malbazar Subdivisional Hospital, Jalpaiguri 735221.
J Indian Med Assoc. 2011 Feb;109(2):74-8.
Musculoskeletal disorders are common in diabetic subjects. The pathophysiology of these disorders in diabetic patients is not obvious. It could be due to connective tissue disorders, glycosylated end products, vasculopathy, neuropathy or combinations. A wide range of musculoskeletal syndromes have been described in association with diabetes, namely diabetic cheiro-arthropathy, adhesive capsulitis of shoulder, carpal tunnel syndrome, Dupuytren's contracture, hyperostosis, osteo-arthritis, hyperuricaemia, etc. This study was undertaken to find out the prevalence of these conditions in diabetes mellitus and to look for any associations with diabetic complications or therapy. A tertiary care centre-based cross-sectional study was carried out among 100 consecutive diabetic patients (WHO criteria) attending medicine department who were enrolled. The study was done at Calcutta National Medical College and Hospital, Kolkata, from March 2008 to February 2009. The diagnoses of the rheumatic conditions were made by unbiased clinical observations on the basis of standardised case definitions or criteria. Limited joint mobility (29%), adhesive capsulitis (18%), and osteo-arthritis of knee (27%) or hand (17%) were the most common rheumatic conditions in diabetics. Trigger finger (flexor tenosynovitis) and carpal tunnel syndrome were also present in 7% and 5% cases of diabetics respectively. Although hyperuricaemia was present in 9%, clinical gout was present in only 4%. There was no clear association of these syndromes with diabetic renal disease or micro-albuminuria. Most of these conditions were noted in chronic long duration diabetic subjects.
肌肉骨骼疾病在糖尿病患者中很常见。这些疾病在糖尿病患者中的病理生理学尚不明确。可能是由于结缔组织疾病、糖基化终产物、血管病变、神经病变或多种因素共同作用。已经描述了多种与糖尿病相关的肌肉骨骼综合征，即糖尿病性手部关节病、肩周炎、腕管综合征、掌腱膜挛缩症、骨质增生、骨关节炎、高尿酸血症等。本研究旨在查明这些病症在糖尿病患者中的患病率，并寻找与糖尿病并发症或治疗的任何关联。在一家三级医疗中心对连续就诊的100例符合世界卫生组织标准的糖尿病患者进行了横断面研究，这些患者均在医学科登记入组。该研究于2008年3月至2009年2月在加尔各答的加尔各答国立医学院和医院进行。根据标准化的病例定义或标准，通过无偏倚的临床观察做出风湿性疾病的诊断。关节活动受限（29%）、肩周炎（18%）以及膝关节（27%）或手部（17%）的骨关节炎是糖尿病患者中最常见的风湿性疾病情况。扳机指（屈指肌腱狭窄性腱鞘炎）和腕管综合征在糖尿病患者中的出现率分别为7%和5%。尽管高尿酸血症的出现率为9%，但临床痛风的出现率仅为4%。这些综合征与糖尿病肾病或微量白蛋白尿之间没有明显关联。这些病症大多在病程较长的慢性糖尿病患者中出现。
