Hand, shoulder and back stiffness in long-term type 1 diabetes; cross-sectional association with skin collagen advanced glycation end-products. The Dialong study.

Abstract

AIMS:

We aimed to: (i) estimate the prevalence of Dupuytren's disease, trigger finger, carpal tunnel syndrome and frozen shoulder; (ii) assess stiffness of the hand, shoulder and back; and (iii) explore the association of joint stiffness with both long-term HbA1c and collagen advanced glycation end-products (AGEs) in long-term type 1 diabetes mellitus (T1DM).

METHODS:

Patients with T1DM from 1970 or earlier attending a specialized diabetes center were included in this cross-sectional controlled study. We collected HbA1/HbA1c measurements from 1980 to 2015 and data on hand and shoulder diagnoses and joint stiffness through interviews, charts, and standardized examination. Skin biopsies were analyzed for collagen AGEs by liquid chromatography-mass spectrometry.

RESULTS:

Lifetime prevalence of hand and shoulder diagnoses in the diabetes group (n=102) ranged from 37%-76% (frozen shoulder) versus 11%-15% in controls (n=73) (p<0.001). There was an association between joint stiffness and long-term HbA1c (odds ratio 2.01 [95% CI 1.10-3.7]) and the AGEs methyl-glyoxal-lysine-dimer (odds ratio 1.68 [95% CI 1.03-2.73]) and pentosidine (odds ratio 1.81 [95% CI 1.04-3.16]).

CONCLUSIONS:

Patients with T1DM >45years had a very high prevalence of hand and shoulder diagnoses versus controls. Joint stiffness was associated with collagen AGEs. However, joint biopsies and prospective studies must explore this association further.

• Authors: Kristine Bech Holte, Niels Gunnar Juel, Jens Ivar Brox, Kristian Folkvord Hanssen, Dag Sigurd Fosmark, David R Sell, Vincent M Monnier, Tore Julsrud Berg
• Journal: Journal of diabetes and its complications (J Diabetes Complications) Vol. 31 Issue 9 Pg. 1408-1414 (Sep 2017) ISSN: 1873-460X [Electronic] United States
• PMID: 28705609 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 Elsevier Inc. All rights reserved.

Chemical References

• Glycation End Products, Advanced
• Collagen

Topics

• Aged
• Back (pathology)
• Collagen (analysis, metabolism)
• Contracture (epidemiology, etiology, metabolism)
• Cross-Sectional Studies
• Diabetes Mellitus, Type 1 (complications, metabolism)
• Female
• Glycation End Products, Advanced (metabolism)
• Hand (pathology)
• Humans
• Male
• Middle Aged
• Musculoskeletal Diseases (epidemiology, etiology, metabolism, pathology)
• Prevalence
• Shoulder (pathology)
• Skin (chemistry, metabolism, pathology)