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Sleep quality in rheumatoid arthritis: relationship between the disease severity, depression, functional status and the quality of life.

Background The aim of this study was to evaluate sleep quality and the related variables in patients with rheumatoid arthritis (RA). Methods Ninety-four patients diagnosed with RA and fifty two healthy controls were enrolled in the study. Disease activity was assessed through the Disease Activity Score (DAS) 28 scale. All patients were assessed using the Rheumatoid Arthritis Quality of Life and Health Assessment Questionnaire scales, together with the Beck Depression Inventory. Radiological damage was calculated with the modified Larsen method. The Pittsburgh Sleep Quality Index (PSQI) was used for the evaluation of the sleep disturbance. Results The patients with RA had significantly higher scores in the subjective sleep quality, sleep latency, habitual sleep efficiency, sleep disturbance domains and the total PSQI score compared to the healthy control group. According to the results of Spearman’s analysis, there was a significantly correlation between the age, disease activity, CRP, pain, fatigue, depression, functional disability, quality of life, radiological damage, menopause status, duration of morning stiffness, ESR levels and the sleep disturbance. The logistic regression analysis indicated that depression and DAS 28 scores were predictors for poor sleep quality. Conclusion The sleep quality is disturbed in patients with RA. The poor sleep quality is especially associated with the disease activity and depression.

Serum prolidase enzyme activity and oxidative status in patients with fibromyalgia

Abstract Objective This study was performed to investigate serum prolidase enzyme activity and oxidative stress in patients diagnosed with fibromyalgia (FM). Methods The study population consisted of 40 patients with a previous diagnosis of FM and 30 healthy subjects. We measured serum prolidase enzyme activity, total antioxidant status (TAS), total oxidative status (TOS), oxidative stress index (OSI), and paraoxonase-1 (PON-1) levels. Results On average, FM patients were diagnosed within 3.2 years of symptom onset, and patients had a mean of 14 tender points. There were no significant differences between patients and controls in age, body mass index, serum TAS, or PON-1 levels. However, patients with FM demonstrated higher serum prolidase activity, TOS, and OSI than the control group. Serum prolidase activity was positively correlated with serum TOS, OSI, and visual analog scale pain and fatigue scores. No correlation was found between serum prolidase activity and FM duration or the average number of tender points. Discussion Our results demonstrate a previously unreported association between serum prolidase enzyme activity and FM. Increased prolidase activity may contribute to the pathogenesis of FM, and measuring serum prolidase enzyme activity may be a useful FM biomarker.

Serum levels of high mobility group box 1 protein and its association with quality of life and psychological and functional status in patients with fibromyalgia

High mobility group box 1 protein (HMGB1) is a proinflammatory cytokine. Previous studies have suggested that HMGB1 can play an important role in the pathogenesis of many rheumatic diseases. The purpose of this study was to investigate the serum levels of HMGB1 in patients with fibromyalgia (FM) and its association with quality of life and psychological and functional status in these patients.

Serum Prolidase Activity in Ankylosing Spondylitis and Rheumatoid Arthritis

The aim of the present study was to emphasize the collagen turnover in 2 of the most common chronic inflammatory rheumatic diseases by evaluating serum prolidase activity (SPA) in ankylosing spondylitis (AS) and rheumatoid arthritis (RA). 30 patients who met the modified New York Criteria for the classification of AS, 29 patients who met the 2010 Rheumatoid Arthritis Classification Criteria for the classification of RA, and 31 healthy controls were enrolled in the study. Serum samples of the patients and the controls were collected and SPA was measured by a spectrophotometric method. The comparison of the SPA in these 3 groups was statistically examined. In both patient groups, the SPA was lower than in the control group. SPA in patients with AS was statistically significantly lower than in the control and RA groups (P < 0.001/P = 0.002). No statistically significant difference was found between the RA and the control groups (P = 0.891). In conclusion, lower SPA is presumably associated with decreased collagen turnover and fibrosis, leading to decreased physical functions in both chronic inflammatory musculoskeletal diseases.

Serum Coenzyme Q10 Levels and Oxidative Status in Patients with Fibromyalgia Syndrome

Abstract Objectives: The aim of this study was to determine the relationship between serum coenzyme Q10 [CoQ10] levels and symptoms of fatigue associated with fibromyalgia syndrome [FMS]. Methods: Patients diagnosed with primary FMS and domographically matching healthy normal controls [HNCs] were sought to participate in the study. The total antioxidant status, total oxidative status, and CoQ10 levels were measured in blood samples from the patients and the controls. Results: A total of 40 patients with FMS and 30 HNCs were recruited. There were no statistically significant differences between the two groups in regard to C-reactive protein, mean erythrocyte sedimentation rate, mean age, and mean body mass index [p > 0.05]. The mean time from symptom onset to diagnosis for the FMS patients was 2.88 years, and the average number of tender points was 14. The serum CoQ10 levels were significantly lower in the FMS patients compared with the HNC group [p = 0.000]. The serum total oxidative status and oxidative stress index levels were higher, and the serum total antioxidant status levels were lower in the FMS patients compared with those of the HNC group [p < 0.05]. The visual analog scale [VAS] pain scores and the VAS fatigue scores were significantly higher in the FMS group than in the HNC group [p = 0.000]. The serum CoQ10 levels were negatively correlated with the mean Modified Fatigue Impact Scale scores [p = 0.02, r = 0.30], VAS pain scores [p = 0.00, r = 0.38], and VAS fatigue scores [p = 0.03, r = 0.28]. Conclusions: The CoQ10 deficiency may contribute to the etiopathogenesis of FMS fatigue.

Effects of lumbosacral angles on development of low back pain

Abstract Objective: Low back pain [LBP] is an important health issue due the diagnosis and treatment expenses and loss of workforce it leads to. Biomechanical changes in the vertebral column caused by changes in the lumbosacral angles [LSAs] may lead to LBP. The purpose of this study was to assess body mass index [BMI] and LSAs in patients with LBP and investigate the association between LBP, LSAs and BMI. Methods: Lumbar lordotic angle [LLA], LSA, sacro-horizontal angle [SHA] and sacral inclination angle [SIA] were measured in 117 patients with chronic LBP and 85 healthy normal controls [HNCs] by means of lumbosacral radiography. In addition, association between LSAs, BMI and LBP was investigated. Results: There were no significant differences between patients and HNCs regarding LSAs and BMI. LLA was lower in male patients with LBP compared to male HNCs without LBP [p = 0.013]. In addition, SIA [p = 0.002] and BMI [p = 0.006] were higher in female patients with LBP compared to male patients with LBP. It was found that an increase in LLA increased the risk of having LPB by approximately 1.04-folds [ranging from 1.01 to 1.08; p = 0.045]. On the other hand, no association was found between LSAs and BMI. Conclusion: Changes in LSAs may cause LBP. An increase in LLA may be influential in increasing the risk of LBP. Therefore, measurement of LSAs may guide the physician who is to make clinical decisions in examination of patients with LBP.

Serum prolidase activity in benign joint hypermobility syndrome

BackgroundModerate joint laxity is widespread in many joints of the body, and this condition is considered to be caused by an abnormality in the collagen structure. This study was carried out to determine the serum prolidase activity in female patients with benign joint hypermobility syndrome (BJHS), and to evaluate its correlation with their clinical features.MethodsA total of 45 patients with BJHS and 40 healthy controls were included in the study. All of the patients with BJHS met the Beighton diagnostic criteria. All the patients and the control group underwent a comprehensive examination of the locomotor system and took the New York Posture Rating Test. The examination and test results were recorded. Serum prolidase activity was measured in both the groups.ResultsProlidase activity was significantly lower in patients with BJHS (479.52 ± 126.50) compared to the healthy controls (555.97 ± 128.77) (p = 0.007). We found no correlation between serum prolidase activity and Beighton scores or New York rating test scores. On the other hand, mean prolidase activity was significantly lower in patients with pes planus or hyperlordosis compared to those without (p = 0.05, p = 0.03, respectively). We did not find such a correlation with the other clinical features.ConclusionsSignificantly lower prolidase activity in patients with BJHS suggests that prolidase may affect the collagen metabolism and cause hyperlaxity.

Serum relaxin levels in benign hypermobility syndrome.

OBJECTIVE In this study, we investigated the activity of serum relaxin in female patients with benign joint hypermobility syndrome (BJHS), locomotor system findings accompanying BJHS, and its relation to relaxin. METHODS Into the study, female patients with BJHS and healthy women as the control group were included. The patients were diagnosed by using the Brighton 1998 criteria. Examination of the locomotor system for study groups were performed. Serum relaxin levels of both patient and control group were measured. RESULTS There were 48 female patients with BJHS and 40 healthy women in the study. With respect to the control group, the level of serum relaxin was higher in the patients (47.1 ± 20.3, 34.4 ± 22.1; p> 0.05). Again compared with the control group, arthralgia (p= 0.00), myalgia (p= 0.01), shoulder impingement syndrome (p= 0.05), pes planus (p= 0.01), and hyperkyphosis (p= 0.000) were higher in the patients. The level of relaxin median was significantly higher in the patients with pesplanus and hyperkyphosis than those who did not have them (p= 0.05, p= 0.01, respectively). CONCLUSIONS Although serum relaxin level is not considered a causative factor for BJHS, the significant increases found in those patients with hyperkyphosis and pes planus suggest the hypothesis that relaxin has a limited and indefinite role in patients with BJHS.

Evaluation of hearing loss in patients with ankylosing spondylitis

Objective: The aim of this study was to evaluate the rate of hearing loss in patients with ankylosing spondylitis (AS) and to ana- lyze whether the rates of hearing loss were different from the control group or not. Materials and Methods: A total of 50 AS patients and 34 healthy controls were enrolled into the study. Physical examinations and disease activity score measurements were performed in patients with AS. Results: The mean age was 32.20 years (18-55) in AS patients and 35.58 (20-50) in the control group. The mean disease dura- tion was 5.27 years (0-22) in patients with AS. Hearing loss was detected in seven (14%) of the AS patients and three (8.8%) of the control patients. In terms of hearing loss, a statistically significant difference was not found between the two groups. Senso - rineural hearing loss was the most commonly detected type of hearing loss in the two groups. Hearing loss was present in two (28.5%) of the seven AS patients in whom the duration of disease was more than 10 years. There was no statistically significant correlation between the duration of disease and hearing loss. Conclusion: There was no significant difference between the AS and control groups with respect to hearing loss. The rate of hearing loss increased in line with the duration of disease.