İpek TÜRK, Neşe Merve KARATAŞ, Göktuğ KARATAŞ

Kan Sayımından Elde Edilen İnflamasyon Parametreleri Ve Diz Osteofitleri Arasındaki İlişki

Giriş/Amaç:Osteoartrit artık sadece dejeneratif bir hastalık olarak kabul edilmemektedir. Altta yatan düşük dereceli inflamasyon varlığı gösterilmiştir. Osteofitler radyolojik evre tespitinde kullanılmasına rağmen gelişim mekanizması tam bilinmemektedir. Bu çalışmanın amacı, tam kan sayımı ile ilişkili çeşitli inflamasyon parametrelerinin osteofitler ve radyolojik evre ile ilişkisinin ayrı ayrı değerlendirilmesidir. Gereç ve Yöntemler:Klinik olarak ACR (American Collage of Rheumatology) diz osteoartriti kriterlerini karşılayan hastalar, geriye dönük olarak seçilmiştir. Kellgren-Lawrence derecelendirme ölçeği hastalık şiddeti için, OARSI (Osteoarthritis research society international grading ) sınıflaması ise osteofit boyutunun değerlendirilmesi için kullanıldı.Tam kan sayımından elde edilen kırmızı kan hücresi dağılım genişliği (RDW), trombosit/lenfosit oranı (PLR), nötrofil/lenfosit oranı (NLR), nötrofil/monosit oranı (NMR), lenfosit/monosit oranı (LMR), ortalama trombosit hacmi (MPV) ve C-reaktif protein (CRP) seviyeleri kaydedildi. İnflamasyon belirteçleri ile osteofitler ve hastalık evresi arasındaki ilişki lojistik regresyon analizi ile değerlendirildi. Bulgular:CRP ve PLR ile hastalığın erken döneminde anlamlı bir korelasyon gösterildi. İleri evre hastalıkta ise herhangi bir korelasyon saptanmadı. Osteofit büyüklüğüne göre bakılan analizde ise osteofit progresyonu ile inflamatuar belirteçler arasında bir korelasyon gösterilememiştir. Sonuç:Sonuçlarımıza göre, sistemik düşük dereceli inflamasyon belirteçleri ile diz osteoartritinin erken evrelerinde bir ilişki olduğu gösterilmiş olup bu ilişki ileri evrelerde saptanmamıştır. Osteofit progresyonu ile bu belirteçler arasında bir ilişki gösterilememiştir. Her ne kadar birlikte seyrediyor gibi olsa dahi hastalığın ilerlemesi ve osteofit oluşumunun farklı mekanizmalara sahip olduğunu varsayabiliriz.

Anahtar Kelimeler:

Diz Osteoartriti, Düşük dereceli inflamasyon, Kellgren-Lawrence evrelemesi, Osteofitler, Tam kan sayımı

Relationship Between Inflammation Parameters Which Are Obtained From Blood Count And Knee Osteophytes

Objective:Osteoarthritis is no longer considered a degenerative disease. The presence of underlying low-grade inflammation has been well demonstrated. Although osteophytes are used to determining the radiological stage, the development mechanism is not fully understood. The aim of this study is to separately evaluate the relationship between various inflammation parameters associated with complete blood count with osteophytes and radiological stage. Methods:Patients who met the American College of Rheumatology clinical knee osteoarthritis criteria, retrospectively selected. Kellgren-Lawrence grading scale was used for disease severity and Osteoarthritis research society international grading was used for osteophyte size evolution. Red blood cell distribution width, platelet to lymphocyte ratio, neutrophil to lymphocyte ratio, neutrophil to monocyte ratio, lymphocyte to monocyte ratio, and mean platelet volume obtained from complete blood count, and C-reactive protein levels were recorded. The relationship between inflammation markers and osteophytes and disease stage was evaluated by logistic regression analysis. Results:A significant correlation was shown between CRP and PLR in the early stage of the disease. No correlation was found in the advanced stage. No correlation was found between osteophyte progression and inflammatory markers in the analysis based on osteophyte size Conclusion:In this study, we have shown that there is a relationship between systemic low-grade markers of inflammation and early stages of knee osteoarthritis, but this relationship was not detected in advanced stages. There was not a relation between osteophyte progression and these markers. Even though it seems to be running together, we can assume that the progression of the disease and osteophyte formation have different mechanisms.

Keywords:

Knee Osteoarthritis, Low-grade inflammation, Kellgren-Lawrence grade, Osteophytes, Complete blood count,

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