Background At present there are many studies of quality of life (QoL) in patients with osteoarthritis (OA) which describe the association between mental health worsens and progression of functional disorders. The influence of insulintherapy metabolic control diabetes (T2DM) complications on QoL and depression has also been proved. However, there is lack of data for studying QoL and mental health in patients with OA and T2DM.
Objectives To explore the QoL parameters and assessment of depression level in patients with knee OA and T2DM.
Methods A case-control study was performed on 92 persons (46 patients with T2DM diagnosed one year before the start of joint disease and 46 subjects without T2DM). All patients who participated in this study had bilateral knee OA according to the ACR criteria. Patients with OA and T2DM were divided into groups according to the duration and the compensation degree T2DM. QoL and depression degree were measured by short form 36 (SF-36) and with patient health questionnaire-9 (PHQ-9). We assessed glycated hemoglobin concentrations (HbA1c) using liquid chromatography for study the dependence of these parameters on the degree of compensation of T2DM. Statistical data are presented as median and 25/75 percentiles. We used U-Mann-Whitney and ANOVA tests to detect differences between selected groups.
Results The median age of group of patients with OA and T2DM (n=46) was 63 (interquartile range (IQR): 55-66) 81% were women. At the patients with OA (n=46) the median age was 63 (IQR: 59-68) 83% were women. Statistically significant differences between two groups were found in all parameters of SF-36 (some data performed in Table). There was showed a tendency of decline in physical functioning (SF-PF) with increasing duration of the T2DM. It was established that patients with T2DM and OA with level of Hb A1c ≥7,5% had very low indicator of role emotional behavior (RE) and statistically significantly different from patients who achieved parameters of HbA1c which was <7.5% (p=0.03). Parameters of QoL also depend on the duration of T2DM and are significantly lower. In the study of depression degree (on the scale PHQ-9) in patients with OA and T2DM it was found depending on the duration and degree of compensation T2DM (depression degree increases from mild to severe). In assessing the condition of the depression in OA patients without T2DM on the scale PHQ-9 it was found that they have light degree and tendency to increase which is related to the long duration of OA. Patients with OA and T2DM were statistically significantly different from patients who has OA (p=0,02).
Conclusions It follows from this study that in patients with OA and T2DM there were changes in depressive disorders, physical and mental health depending on the compensation degree and duration of T2DM. This data should be verified by larger studies and may be the basis for an integrated program of rehabilitation of patients with comorbid disorders such as OA and T2DM.
Holla JF et al. Prognostic factors for the two-year course of activity limitations in early osteoarthritis of the hip and/or knee: results from the CHECK cohort. Arthritis Care Res 2010.
Ali, S et al. The association between depression and health-related quality of life in people with type 2 diabetes. Diabetes/metabolism 2010.
Disclosure of Interest None declared