ORIJINAL ARAŞTIRMA
Fibromiyalji Tanılı Hastalarda B12 Vitamini, D Vitamini, Magnezyum Düzeyleri ile Düşme Riski İlişkisi
The Relationship Between Vitamin B12, Vitamin D, Magnesium Levels and Fall Risk in Patients with Fibromyalgia
Received Date : 04 Aug 2022
Accepted Date : 06 Sep 2023
Available Online : 11 Sep 2023
Köksal SARIHANa, Hülya UZKESERb
aOltu Devlet Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Erzurum, Türkiye
bAtatürk Üniversitesi Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Erzurum, Türkiye
Doi: 10.31609/jpmrs.2022-92756 - Makale Dili: TR
J PMR Sci 2024;27(1):1-10.
ÖZET
Amaç: Fibromiyalji sendromu (FMS) hastalarında fonksiyonelliği
etkileyen semptomlardan biri de denge kaybıdır. Bu çalışmada, FMS tanılı
kadın hastalarda düşme riski ile B12 vitamini, D vitamini, magnezyum düzeyleri
ve bazı klinik özelliklerin ilişkisinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntemler: Çalışmaya FMS tanılı, 18-60 yaş arası, ardışık 60
kadın hasta ve 60 sağlıklı kadın gönüllü alındı. Katılımcılara ağrı için görsel
analog skala, hastalık aktivitesi için Fibromiyalji Etki Anketi, düşmenin
etkisi için Düşme Etkinlik Ölçeği ve depresyon için Beck Depresyon Anketi
uygulandı. Postürografi cihazı ile kantitatif olarak düşme riskleri belirlendi.
Son olarak; fibromiyalji tanılı grup ile kontrol grubu arasında ve ilaveten
fibromiyaljili grubun kendi içinde alt gruplar oluşturularak düşme riski, etkisi,
sayısı, B12, D vitamini ve magnezyum düzeyleri ve çeşitli klinik özellikler
açısından istatistiksel karşılaştırmalar yapıldı. Bulgular:
Çalışmamızda FMS olan kadınların, kontrol grubuna göre düşme risk indekslerinin
(medyan; %44-%28), düşme sayısı (medyan; 2-1) ve etkisinin
(medyan; 22-11,5) anlamlı olarak yüksek olduğu tespit edildi. FMS grubunda
parestezi mevcudiyeti ve FMS için ilaç kullanımı daha yüksek düşme
riski (p: 0,029) ve etkisi (p: 0,012) ile ilişkili bulundu. Yine FMS grubunda
beden kitle indeksi artışı daha yüksek düşme riski (p: 0,019) ile ve yaşın
ileri olması ise daha yüksek Düşme Etkinlik Ölçeği skoru (p<0,001) ile ilişkili
bulundu. Sonuç: FMS hastalarında düşme riskinin topluma göre daha
yüksek olduğu, ilaç kullanımının riski daha da artırdığı ve B12 vitamini, D
vitamini ve magnezyum düzeylerinin düşme riski ile direkt ilişkili olmadığı
tespit edildi. Bu sonuçlar ile FMS hastalarında denge fonksiyonları için egzersiz
programları dâhil ek önlemlerin alınması ve denge ile ilgili çalışma
sayısının artırılması gerektiği ortaya konuldu.
Anahtar Kelimeler: Fibromiyalji sendromu; düşme riski; B12 vitamini; D vitamini; magnezyum
ABSTRACT
Objective: One of the symptoms affecting functionality in
patients with fibromyalgia syndrome (FMS) is loss of balance. In this study,
it was aimed to evaluate the relationship between fall risk and vitamin B12,
vitamin D, magnesium levels and some clinical features in female patients
with FMS. Material and Methods: Sixty consecutive female patients diagnosed
with FMS, aged 18-60 years, and 60 healthy female volunteers were
included in the study. Participants were administered the visual analog scale
for pain, the Fibromyalgia Impact Questionnaire for disease activity, the
Fall Activity Scale for the effectiveness of falling, and the Beck Depression
Questionnaire for depression. The risk of falling was determined quantitatively
with the posturography device. Finally; Statistical comparisons were
made between the fibromyalgia group and the control group, as well as
within the fibromyalgia group, in terms of fall risk, effectiveness, number,
B12, vitamin D and magnesium levels, and various clinical features. Results:
In our study, it was determined that the fall risk indexes (median;
44%-28%), number of falls (median; 2-1) and effectiveness (median; 22-
11,5) of women with FMS were significantly higher than the control group.
Presence of paresthesia and drug use for FMS were associated with higher
fall risk (p: 0,029) and efficacy (p: 0,012) in the FMS group. Again, in the
FMS group, an increase in body mass index was associated with a higher
risk of falling (p: 0,019), and older age was associated with a higher fall efficiency
scale score (p<0,001). Conclusion: It was determined that the risk
of falling is higher in FMS patients than in the general population, drug use
increases the risk even more, and vitamin B12, vitamin D and magnesium
levels are not directly related to the risk of falling. With these results, it was
revealed that additional measures, including exercise programs, should be
taken for balance functions in FMS patients and the number of studies on
balance should be increased.
Keywords: Fibromyalgia syndrome; fall risk; vitamin B12; vitamin D; magnesium
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