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成年非胰岛素依赖型糖尿病患者的关节活动受限(手部关节病)

Limitation of joint mobility (cheiroarthropathy) in adult noninsulin-dependent diabetic patients.

作者信息

Fitzcharles M A, Duby S, Waddell R W, Banks E, Karsh J

出版信息

Ann Rheum Dis. 1984 Apr;43(2):251-4. doi: 10.1136/ard.43.2.251.

Abstract

Joint mobility was assessed in 80 consecutive adult noninsulin-dependent diabetic (NIDD) patients and 47 nondiabetic controls matched for age and sex. Impairment of mobility was observed in 36 NIDD patients but only 7 controls (p less than 0.01). There was no significant differences between diabetic patients with and without impaired mobility with regards to age, duration of diabetes, mean daily insulin dose, or overall diabetic control as assessed by the measurement of glycosylated haemoglobin (HbA1C). However, NIDD patients with impaired joint mobility had a significantly increased frequency of microvascular disease, as shown by retinopathy and/or nephropathy (42% versus 22%, p less than 0.05), were more often on insulin treatment (86% versus 63%, p less than 0.05) and more frequently had additional rheumatic disorders such as Dupuytren's contracture and osteoarthritis (36% versus 18%, p less than 0.05). In addition tight waxy skin over the phalanges was commonly associated with impaired mobility (58% versus 22%, p less than 0.01). Limitation of joint mobility was most prominent in the hands but caused no functional impairment. This finding may be an additional marker of microvascular disease in the adult diabetic patient.

摘要

对80例连续的成年非胰岛素依赖型糖尿病(NIDD)患者和47例年龄及性别相匹配的非糖尿病对照者进行了关节活动度评估。36例NIDD患者存在活动度受损,而对照者中只有7例(p<0.01)。在年龄、糖尿病病程、平均每日胰岛素剂量或通过糖化血红蛋白(HbA1C)测量评估的总体糖尿病控制方面,活动度受损和未受损的糖尿病患者之间没有显著差异。然而,关节活动度受损的NIDD患者微血管疾病的发生率显著增加,如视网膜病变和/或肾病所示(42%对22%,p<0.05),更常接受胰岛素治疗(86%对63%,p<0.05),并且更频繁地患有其他风湿性疾病,如杜普伊特伦挛缩和骨关节炎(36%对18%,p<0.05)。此外,指骨上紧绷的蜡样皮肤通常与活动度受损相关(58%对22%,p<0.01)。关节活动度受限在手部最为明显,但未导致功能障碍。这一发现可能是成年糖尿病患者微血管疾病的一个额外标志。

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