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ORIJINAL ARAŞTIRMA
Karpal Tünel Sendromu Tanılı Hastalarda Vitamin D, Vitamin B12 ve Folik Asit Düzeylerinin Değerlendirilmesi
Evaluation of Vitamin D, Vitamin B12 and Folic Acid Levels in Patients with Carpal Tunnel Syndrome
Received Date : 29 Dec 2021
Accepted Date : 07 Jun 2021
Available Online : 18 Jun 2021
Özet PDF Benzer Makaleler
Emre SAĞIRa, Nurdan YILMAZb, Hülya DEVECİb
aGaziantep Şehitkamil Devlet Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Gaziantep, TÜRKİYE bTokat Gaziosmanpaşa Üniversitesi Tıp Fakültesi Araştırma ve Uygulama Hastanesi, Fiziksel Tıp ve Rehabilitasyon ABD, Tokat, TÜRKİYE
Doi: 10.31609/jpmrs.2020-78323 - Makale Dili: TR
J PMR Sci. 2021;24(3):201-7
ÖZET
Amaç: Karpal Tünel Sendromu (KTS), en sık görülen tuzak nöropatilerinden biridir. D vitamininin nöroprotektif etkileri, B12 vitamini ve folik asidin miyelin yapımındaki etkilerinden dolayı bu vitaminlerin KTS patogenezinde rolü olabilir. Bu çalışmada, KTS’li hastalarda serum 25(OH) vitamin D, vitamin B12 ve folik asit düzeylerini araştırmayı ve bu vitaminler ile KTS şiddeti arasında ilişki olup olmadığını değerlendirmeyi amaçladık. Gereç ve Yöntemler: Kesitsel olarak yapılan çalışmaya 18-70 arası, klinik ve elektromiyografik (EMG) olarak KTS tanısı konulan 100 hasta ile 40 sağlıklı kontrol dâhil edildi. Hasta grubu EMG sonuçlarına göre hafif, orta, şiddetli KTS olmak üzere 3 alt gruba ayrıldı. Hasta ve kontrol grubundaki tüm bireylerin serum 25(OH) vitamin D, vitamin B12 ve folik asit düzeyleri değerlendirildi. Hasta grubuna ayrıca vizüel analog skala (VAS), Boston Karpal Tünel Sendromu Anketi (BKTSA) ve “The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS)” ağrı ölçeği uygulandı. Bulgular: Hastaların 30’u (%30) hafif, 49’u (%49) orta ve 21’i (%21) ağır KTS idi. Tüm gruplarda (hasta alt grupları ve kontrol) D vitamini düzeyleri düşüktü ancak gruplar arasında istatistiksel anlamlı bir fark yoktu. B12 vitamini ve folik asit düzeyleri tüm gruplarda normal aralıklardaydı ve gruplar arasında istatistiksel olarak anlamlı bir fark yoktu (p>0,05). KTS şiddeti ile D vitamini, B12 vitamini ve folik asit arasında herhangi bir korelasyon bulunamadı. Aynı şekilde KTS şiddeti ile VAS, BKTSA ve LANSS skorları arasında da korelasyon saptanmadı (p>0,05). Sonuç: Çalışmamızda, KTS’li hastalarda serum vitamin D, vitamin B12 ve folik asit düzeylerinde ve bu vitaminlerin klinik ölçeklerle korelasyonunda istatistiksel anlamlı bir ilişki bulunamadı. Bu vitaminlerin nöroprotektif etkileri ve miyelin yapımındaki fonksiyonlarından dolayı KTS klinik ve patogenezindeki olası rolünü anlayabilmek için geniş hasta gruplarını içeren farklı çalışmalara ihtiyaç vardır.
Anahtar Kelimeler: Karpal tünel sendromu; vitamin D; vitamin B12; folik asit; nöropati
ABSTRACT
Objective: Carpal Tunnel Syndrome (CTS) is one of the most common entrapment neuropathies. Due to the neuroprotective effects of vitamin D and the effects of vitamin B12 and folic acid on myelin production, these vitamins may have a role in the pathogenesis of CTS. In this study, we aimed to investigate serum 25 (OH) vitamin D, vitamin B12 and folic acid levels in patients with CTS and to evaluate whether there is a relationship between these vitamins and the severity of CTS. Material and Methods: A total of 100 patients diagnosed with clinically and electromyographically (EMG) CTS between the ages of 18-70 years, and 40 healthy volunteers were included in the cross-sectional study. The patient group was divided into 3 subgroups according to EMG results as mild, moderate and severe CTS. Serum 25 (OH) vitamin D, vitamin B12 and folic acid levels of all individuals in the patient and control groups were evaluated. Visual analogue scale (VAS), Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) and The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain scale were also applied to the patient group. Results: Thirty (30%) of the patients were mild, 49 (49%) moderate and 21 (21%) severe CTS. Vitamin D levels were low in all groups (patient subgroups and control), but there was no statistically significant difference between the groups. Vitamin B12 and folic acid levels were within normal ranges in all groups and there was no statistically significant difference between the groups (p>0.05). No relationship was found between the severity of CTS and vitamin D, vitamin B12 and folic acid. Similarly, there was no correlation between CTS severity and VAS, BCTSQ and LANSS scores (p>0.05). Conclusion: In our study, no statistically significant relationship was found between serum vitamin D, vitamin B12 and folic acid levels and the correlation of these vitamins with clinical scales in patients with CTS. Due to the neuroprotective effects of these vitamins and their functions in myelin production, different studies involving large patient groups are needed to understand their possible role in the clinical and pathogenesis of CTS.
Keywords: Carpal tunnel syndrome; vitamin D; vitamin B12; folic acid; neuropathy
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