Kalamegam Surya, Shah Pankaj B, Damodaran Akshaya
Community Medicine, Panimalar Medical College Hospital & Research Institute, Chennai, IND.
Community Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Cureus. 2024 Jul 13;16(7):e64493. doi: 10.7759/cureus.64493. eCollection 2024 Jul.
Introduction Diabetes and osteoarthritis (OA) are prevalent chronic conditions, often occurring concurrently and complicating patient management. While the individual impact of each condition on functional impairment is well documented, their combined effect remains poorly understood. This study aims to elucidate the relationship between diabetes and OA-related functional impairment. Methodology This was a cross-sectional study of 290 participants with unilateral knee OA. Their demographic, clinical, and diabetes data were collected. Functional impairment was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index-Center for Rheumatic Diseases (WOMAC-CRD). Statistical analyses investigated the relationships between diabetes, OA severity, and functional impairment. Result Diabetic participants showed significantly worse physical function and overall disability, with lower WOMAC-CRD scores. Mean WOMAC-CRD pain scores were 6.46 (SD = 1.088) and 6.48 (SD = 1.101) for the diabetic and non-diabetic groups, respectively. Mean WOMAC-CRD stiffness scores were 6.48 (SD = 1.101) and 6.56 (SD = 1.083) for diabetic and non-diabetic groups. Diabetic participants had a mean WOMAC-CRD physical function score of 55.93 (SD = 2.484), compared to 64.02 (SD = 2.542) for non-diabetic participants. The mean total WOMAC score was 68.80 (SD = 2.857) for diabetic participants and 77.06 (SD = 2.933) for non-diabetic participants. Longer diabetes duration correlated negatively with physical function and total WOMAC scores. Discussion The findings suggest that diabetes exacerbates functional impairment in OA patients, particularly affecting physical function and overall disability. Chronic inflammation and the accumulation of advanced glycation end-products may contribute to the observed deterioration in joint function. Conclusion Integrated management strategies addressing both diabetes and OA are essential for optimizing patient care.
引言 糖尿病和骨关节炎（OA）是常见的慢性疾病，常同时发生并使患者管理复杂化。虽然每种疾病对功能障碍的个体影响已有充分记录，但它们的综合影响仍知之甚少。本研究旨在阐明糖尿病与OA相关功能障碍之间的关系。
方法 这是一项对290名单侧膝关节OA患者的横断面研究。收集了他们的人口统计学、临床和糖尿病数据。使用西安大略和麦克马斯特大学骨关节炎指数-风湿病中心（WOMAC-CRD）评估功能障碍。统计分析研究了糖尿病、OA严重程度和功能障碍之间的关系。
结果 糖尿病参与者的身体功能和总体残疾状况明显更差，WOMAC-CRD评分更低。糖尿病组和非糖尿病组的WOMAC-CRD疼痛评分均值分别为6.46（标准差 = 1.088）和6.48（标准差 = 1.101）。糖尿病组和非糖尿病组的WOMAC-CRD僵硬评分均值分别为6.48（标准差 = 1.101）和6.56（标准差 = 1.083）。糖尿病参与者的WOMAC-CRD身体功能评分均值为55.93（标准差 = 2.484），而非糖尿病参与者为64.02（标准差 = 2.542）。糖尿病参与者的WOMAC总分均值为68.80（标准差 = 2.857），非糖尿病参与者为77.06（标准差 = 2.933）。糖尿病病程越长，与身体功能和WOMAC总分呈负相关。
讨论 研究结果表明，糖尿病会加剧OA患者的功能障碍，尤其影响身体功能和总体残疾状况。慢性炎症和晚期糖基化终产物的积累可能导致观察到的关节功能恶化。
结论 针对糖尿病和OA的综合管理策略对于优化患者护理至关重要。
