Faruk KILINÇ, Ahmet KARATAŞ, Ramazan Fazıl AKKOÇ, Gamze AYAZ, Kader UĞUR, Suna AYDIN, Tansel Ansal BALCI, Fikri Selçuk ŞİMŞEK, Umut AYDIN, Vehbi PEHLİVAN

Diyabetik Ayak Hastalarında Anksiyete-Depresyon Bozukluğu ve Kemik Mineral Yoğunluğu

Amaç: Bu çalışmada diyabetik ayağı (DA) olan ve diyabetik ayağı olmayan (DAO) diyabet hastalarının biyokimyasal ölçümleri, depresyon ve anksi-yete skorlaması açısından değerlendirilmesi ve kemik mineral yoğunluklarının (KMY) birbirleriyle karşılaştırılması da yapılarak aralarında bir ilişki-nin olup olmadığının ortaya çıkarılması amaçlanmaktadır. Gereç ve Yöntem: Fırat Üniversitesi Hastanesi’ne başvuran DA tanılı 37 hasta ve DAO grubunda 40 diyabetik hasta, Hastane Anksiyete Depresyon Skorlamasına göre çalışmaya dahil edildi. HbA1c, magnezyum (Mg), albumin, üre, kreatinin, kalsiyum (Ca), fosfor (P), parathormon, D vitamini değerleri, vücut kitle indeksi (VKİ) ölçümlerine ek olarak diyabetik ayağı olanlar Wagner sınıflandırmasına göre değerlendirildi. Ayrıca hastaların lumbal ve femur başı bölgelerinden Dual X-Ray Absorbsiyometri cihazı ile KMY ölçüldü. Bulgular: DA olan ve olmayan her iki grupta da cinsiyet olarak kadın hastalarda depresyon ve anksiyete skorları kayda değer şekilde daha yüksek ve yine kadınlarda KMY değeri anlamlı daha düşük saptandı. Her iki grupta da VKİ arttıkça depresyon ve anksiyete skorları artmaktaydı ancak anlamlı değildi. DA grubunda KMY sonucu istatistiksel olarak anlamlı değildi. VKİ ile KMY arasında pozitif korelasyon bulundu. Ayrıca DA grubundaki Ca, P, Mg'nin DAO grubundakinden önemli ölçüde daha düşük olduğu bulundu. Sonuç: Diyabetik ayak hastalarında, anksiyete, depresyon ve VKİ artarken, KMY azalmaktadır. Dolayısı ile diyabetik ayak komplikasyonu sadece endokrin ve metabolizma bozukluğu olmadığından, psikiyatri dahil multidisipliner bir yaklaşımla tedavi edilmesi gerekmektedir.

Anxiety-Depression Disorders and Bone Mineral Density in Diabetic Foot Patients

Objective: In this study it is aimed to evaluate the depression and anxiety scores as well as biochemical measures in diabetic foot (DF) and none diabetic foot (Non-DF) patients, also to compare the bone mineral densitometry (BMD) measures in order to point out any possible correlation. Material and Method: Diabetic patients who admitted to Firat University Hospital among which 37 had a diagnosis of DF and 40 Non-DF were included in the study according to the Hospital Anxiety and Depression Scale. HbA1c, magnesium (Mg), albumin, urea, creatinine, calcium (Ca), phosphorus (P), parathormone, vitamin D levels and body mass index. (BMI) were recorded for all patients and Wagner classification scores are noted for the cases with DF. In addition, BMD was measured via Dual-energy X-ray absorptiometry from lumbar region and femoral head. Results: The depression and anxiety scores were both significantly higher in female patients DF or Non-DF. It is also reported that the BMD scores were significantly lower in female patients. Results of bone mineral densitometry were not statistically significant in the DF group. There was a positive correlation between BMI and BMD. Also, it has been found that Ca, P, Mg in DF were remarkably lower than in Non-DF. Conclusion: Anxiety, depression and BMI increase while BMD decreases in diabetic foot patients. Diabetic foot complications are not only conside-red as endocrine and metabolic disorders, so that they should be treated with a multidisciplinary approach including psychiatry.5, Ramazan Fazıl AKKOÇ6, Fikri Selçuk ŞİMŞEK7,2Fırat Üniversitesi Tıp Fakültesi, Nükleer Tıp Anabilim Dalı, Elazığ, Türkiye 3Fırat Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı Romatoloji Bilim Dalı, Elazığ, Türkiye 4Fırat Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Elazığ, Türkiye

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