Abstract
Dupuytren disease is a chronic hand condition, characterized by an overgrowth of fibrous tissue in the palmar side of the hand. The fibrous tissue forms nodules and cords that can eventually result in contractures of the fingers. Currently, there is no treatment to prevent or cure this disease.
The primary finding of this thesis is that Dupuytren disease progresses (worsens) over time in the majority of the participants. This is indicated by growth of existing nodules and cords, by formation of new nodules and cords, and by an increase of contractures of the finger joints. However, there were also participants with stability or regression. Another important finding is that the majority of the expected risk factors for disease progression, were not identified as predictors for progression in this study. This suggests that future studies should shift focus from clinical predictors to other factors to predict disease course.
These findings were obtained from a unique prospective cohort study including 258 participants with Dupuytren disease, who were followed-up for 4.5
years with intervals of 6 months. The collected data may form the basis for a model that can predict disease progression, which will be of great help in surgical decision-making about whether and when a patient has to be treated.
This thesis also provides predicted prevalence rates of Dupuytren disease as function of age and sex. This information can be used to estimate prevalence rates in other countries. Furthermore, several risk factors were identified to be linked to Dupuytren disease, namely diabetes mellitus, liver disease, epilepsy, but also field hockey playing (possibly due to mechanical load). The causal relations of these associations should be elucidated in future studies.
In addition to this, a new measurement method to determine Dupuytren disease extent was introduced and tested. Additionally, some frequently used hand function questionnaires were tested to evaluate whether they are able to measure disease progression in Dupuytren disease patients.
Epidemiologic studies as presented in this thesis help focusing future studies that might eventually lead to prevention, or at least, a cure.
The primary finding of this thesis is that Dupuytren disease progresses (worsens) over time in the majority of the participants. This is indicated by growth of existing nodules and cords, by formation of new nodules and cords, and by an increase of contractures of the finger joints. However, there were also participants with stability or regression. Another important finding is that the majority of the expected risk factors for disease progression, were not identified as predictors for progression in this study. This suggests that future studies should shift focus from clinical predictors to other factors to predict disease course.
These findings were obtained from a unique prospective cohort study including 258 participants with Dupuytren disease, who were followed-up for 4.5
years with intervals of 6 months. The collected data may form the basis for a model that can predict disease progression, which will be of great help in surgical decision-making about whether and when a patient has to be treated.
This thesis also provides predicted prevalence rates of Dupuytren disease as function of age and sex. This information can be used to estimate prevalence rates in other countries. Furthermore, several risk factors were identified to be linked to Dupuytren disease, namely diabetes mellitus, liver disease, epilepsy, but also field hockey playing (possibly due to mechanical load). The causal relations of these associations should be elucidated in future studies.
In addition to this, a new measurement method to determine Dupuytren disease extent was introduced and tested. Additionally, some frequently used hand function questionnaires were tested to evaluate whether they are able to measure disease progression in Dupuytren disease patients.
Epidemiologic studies as presented in this thesis help focusing future studies that might eventually lead to prevention, or at least, a cure.
| Translated title of the contribution | Epidemiologie van de ziekte van Dupuytren ontrafeld: Prevalentie, risicofactoren en natuurlijk beloop |
|---|---|
| Original language | English |
| Qualification | Doctor of Philosophy |
| Awarding Institution |
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| Supervisors/Advisors |
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| Award date | 27-Sept-2017 |
| Place of Publication | [Groningen] |
| Publisher | |
| Print ISBNs | 978-90-367-9986-7 |
| Electronic ISBNs | 978-90-367-9985-0 |
| Publication status | Published - 2017 |