Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Post Box 4956, Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Postboks 1078, Blindern, 0316 Oslo, Norway.
Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Post Box 4956, Nydalen, 0424 Oslo, Norway.
J Diabetes Complications. 2017 Sep;31(9):1408-1414. doi: 10.1016/j.jdiacomp.2017.06.007. Epub 2017 Jun 22.
We aimed to: (i) estimate the prevalence of Dupuytren's disease, trigger finger, carpal tunnel syndrome and frozen shoulder; (ii) assess stiffness of the hand, shoulder and back; and (iii) explore the association of joint stiffness with both long-term HbA and collagen advanced glycation end-products (AGEs) in long-term type 1 diabetes mellitus (T1DM).
Patients with T1DM from 1970 or earlier attending a specialized diabetes center were included in this cross-sectional controlled study. We collected HbA/HbA measurements from 1980 to 2015 and data on hand and shoulder diagnoses and joint stiffness through interviews, charts, and standardized examination. Skin biopsies were analyzed for collagen AGEs by liquid chromatography-mass spectrometry.
Lifetime prevalence of hand and shoulder diagnoses in the diabetes group (n=102) ranged from 37%-76% (frozen shoulder) versus 11%-15% in controls (n=73) (p<0.001). There was an association between joint stiffness and long-term HbA (odds ratio 2.01 [95% CI 1.10-3.7]) and the AGEs methyl-glyoxal-lysine-dimer (odds ratio 1.68 [95% CI 1.03-2.73]) and pentosidine (odds ratio 1.81 [95% CI 1.04-3.16]).
Patients with T1DM >45years had a very high prevalence of hand and shoulder diagnoses versus controls. Joint stiffness was associated with collagen AGEs. However, joint biopsies and prospective studies must explore this association further.
我们旨在：（i）估计 1970 年或更早发病的 1 型糖尿病患者中，患有杜普伊特伦挛缩症、扳机指、腕管综合征和冻结肩的流行率；（ii）评估手部、肩部和背部的僵硬程度；（iii）探讨关节僵硬与长期糖化血红蛋白（HbA）和胶原蛋白晚期糖基化终产物（AGEs）之间的关联。
本横断面对照研究纳入了来自专门糖尿病中心的 1970 年或更早发病的 1 型糖尿病患者。我们收集了 1980 年至 2015 年的 HbA/HbA 测量值，并通过访谈、图表和标准化检查收集了手部和肩部诊断以及关节僵硬的数据。通过液相色谱-质谱法分析皮肤活检标本中的胶原蛋白 AGEs。
糖尿病组（n=102）终生手部和肩部诊断的患病率为 37%-76%（冻结肩），而对照组（n=73）为 11%-15%（p<0.001）。关节僵硬与长期 HbA（比值比 2.01[95%CI 1.10-3.7]）和 AGEs 甲基乙二醛赖氨酸二聚体（比值比 1.68[95%CI 1.03-2.73]）和戊糖素（比值比 1.81[95%CI 1.04-3.16]）呈正相关。
45 岁的 1 型糖尿病患者手部和肩部诊断的患病率明显高于对照组。关节僵硬与胶原蛋白 AGEs 有关。然而，关节活检和前瞻性研究必须进一步探讨这种关联。
