The Journal of the American Osteopathic Association, 2005/07, 105(7):317-318. doi: 10.7556/jaoa.2005.105.7.317, type of study: ,ccs,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2005.105.7.317/html)

Keywords:

case control study [58]
depression [77]
diabetes [54]
hypertension [41]

Abstract:

Hypothesis: Osteopathic palpatory findings may represent viscerosomatic manifestations of disease. Methods: This study was performed as a secondary analysis of data acquired from a case-control study of type 2 diabetes mellitus conducted at the University of North Texas Health Science Center during 2002-2003. Standardized osteopathic palpatory examinations were performed by predoctoral osteopathic manipulative medicine fellows who were blinded to each subject’s case-control status. These examinations determined the presence or absence of skin changes, trophic changes, tissue changes, tenderness, and immobility at spinal segments T5-T7, T8-T10, and T11-L2 on either the left or right side. Multiple logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for osteopathic palpatory findings associated with age, sex, hypertension, type 2 diabetes mellitus, and depression. Results: Of the 93 subjects included, 39 (42%) had hypertension, 60 (65%) had type 2 diabetes mellitus, and 30 (32%) had depression. The overrepresentation of type 2 diabetes mellitus cases reflects the purpose of the primary study. Generally, age was not significantly associated with osteopathic palpatory findings. Men were more often found to have skin and trophic changes than women, but men were less often found to have tenderness than women. Hypertension was significantly associated with bilateral trophic changes in each of the three spinal segments (OR, 3.73; 95% CI, 1.28-10.83 for left T5-T7; OR, 5.55; 95% CI, 1.93-15.90 for right T5-T7; OR, 3.91; 95% CI, 1.37-11.20 for left T8-T10; OR, 3.49; 95% CI, 1.25-9.75 for right T8-T10; OR, 12.33; 95% CI, 3.25-46.74 for left T11- L2; and OR, 4.83; 95% CI, 1.59-14.67 for right T11-L2). Conclusions: Hypertension is strongly associated with bilateral trophic changes at T5-T7, T8-T10, and T11-L2. This study is unique in controlling for age, sex, and other comorbid conditions. Additional research is warranted to replicate these findings in a prospective manner and to determine if, and how, trophic changes are caused by hypertension.