J Clin Neurol.  2015 Jul;11(3):234-240. 10.3988/jcn.2015.11.3.234.

On the Severity of Carpal Tunnel Syndrome: Diabetes or Metabolic Syndrome

• Gul Yurdakul F
• Bodur H
• Oztop Cakmak O
• Ates C
• Sivas F
• Eser F
• Yilmaz Tasdelen O

• KMID: 1894556
• DOI: http://doi.org/10.3988/jcn.2015.11.3.234

Abstract

BACKGROUND AND PURPOSE
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Although its etiology is unknown, certain conditions are commonly associated with CTS, such as obesity, arthritis, hypothyroidism, diabetes mellitus, trauma, mass lesions, amyloidosis, and sarcoidosis. We aimed to determine the association between metabolic syndrome and CTS, and we compared the severity of CTS between patients with diabetes (and no concomitant metabolic syndrome) and patients with metabolic syndrome.
METHODS
Two hundred patients with a clinically and electrophysiological confirmed diagnosis of CTS were included in the study. Their demographic characteristics and severity of CTS were analyzed according to the presence or the absence of metabolic syndrome. Differences in the electrophysiological findings were evaluated between the following four groups: 1) metabolic syndrome alone (n=52), 2) diabetes alone (n=20), 3) combined metabolic syndrome and diabetes (n=44), and 4) no metabolic syndrome or diabetes (n=84).
RESULTS
CTS was more severe in the patients with metabolic syndrome than those without this syndrome. The electrophysiological findings were worse in patients with metabolic syndrome alone than in those with diabetes alone and those without diabetes and metabolic syndrome.
CONCLUSIONS
CTS appears to be more severe in patients with metabolic syndrome than patients with diabetes. Diabetes is one of the well-known risk factors for CTS, but other components of metabolic syndrome may have a greater effect on the severity of CTS.

Keyword

carpal tunnel; severity; metabolic syndrome; diabetes; electrophysiology; obesity

MeSH Terms

Amyloidosis
Arthritis
Carpal Tunnel Syndrome*
Diabetes Mellitus
Diagnosis
Electrophysiology
Humans
Hypothyroidism
Obesity
Risk Factors
Sarcoidosis

Reference

1. Geoghegan JM, Clark DI, Bainbridge LC, Smith C, Hubbard R. Risk factors in carpal tunnel syndrome. J Hand Surg Br. 2004; 29:315–320.

2. Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I. Prevalence of carpal tunnel syndrome in a general population. JAMA. 1999; 282:153–158.

3. Nathan PA, Istvan JA, Meadows KD. A longitudinal study of predictors of research-defined carpal tunnel syndrome in industrial workers: findings at 17 years. J Hand Surg Br. 2005; 30:593–598.

4. de Krom MC, de Krom CJ, Spaans F. [Carpal tunnel syndrome: diagnosis, treatment, prevention and its relevance to dentistry]. Ned Tijdschr Tandheelkd. 2009; 116:97–101.

5. LeBlanc KE, Cestia W. Carpal tunnel syndrome. Am Fam Physician. 2011; 83:952–958.

6. da Costa BR, Vieira ER. Risk factors for work-related musculoskeletal disorders: a systematic review of recent longitudinal studies. Am J Ind Med. 2010; 53:285–323.

7. Zimmet PZ, Alberti KG, Shaw JE. Mainstreaming the metabolic syndrome: a definitive definition. Med J Aust. 2005; 183:175–176.

8. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001; 285:2486–2497.

9. Balci K, Utku U. Carpal tunnel syndrome and metabolic syndrome. Acta Neurol Scand. 2007; 116:113–117.

10. Onder B, Yalçın E, Selçuk B, Kurtaran A, Akyüz M. Carpal tunnel syndrome and metabolic syndrome co-occurrence. Rheumatol Int. 2013; 33:583–586.

11. Oh SJ. Nerve conduction in focal neuropathies. In : Oh SJ, editor. Clinical Electromyography: Nerve Conduction Studies. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins;2003. p. 623–633.

12. Stevens JC. AAEE minimonograph #26: the electrodiagnosis of carpal tunnel syndrome. Muscle Nerve. 1987; 10:99–113.

13. Nakamichi K, Tachibana S. Hypercholesterolemia as a risk factor for idiopathic carpal tunnel syndrome. Muscle Nerve. 2005; 32:364–367.

14. Kurt S, Kisacik B, Kaplan Y, Yildirim B, Etikan I, Karaer H. Obesity and carpal tunnel syndrome: is there a causal relationship? Eur Neurol. 2008; 59:253–257.

15. Umay E, Polat S, Ünlü E, Çelik Ö, Çakcı A. Demographic characteristics of our patients with carpal tunnel syndrome. J Clin Anal Med. 2011; 2:63–65.

16. Özgenel GY, Bayraktar A, Özbek S, Akın S, Kahveci R. Karpal tünel sendromu: 92 olgunun geriye dönük değerlendirilmesi. Uludag Med J. 2010; 36:95–98.

17. Lewańska M, Walusiak-Skorupa J. [Etiological factors of carpal tunnel syndrome in subjects occupationally exposed to monotype wrist movements]. Med Pr. 2014; 65:261–270.

18. Doupa D, Mbengue AS, Diallo FA, Jobe M, Ndiaye A, Kane A, et al. Lipid profile frequency and the prevalence of dyslipidaemia from biochemical tests at Saint Louis University Hospital in Senegal. Pan Afr Med J. 2014; 17:75.

19. Ergör G, Soysal A, Sözmen K, Ünal B, Uçku R, Kılıç B, et al. Balcova heart study: rationale and methodology of the Turkish cohort. Int J Public Health. 2012; 57:535–542.

20. Spahn G, Wollny J, Hartmann B, Schiele R, Hofmann GO. [Metaanalysis for the evaluation of risk factors for carpal tunnel syndrome (CTS) Part I. General factors]. Z Orthop Unfall. 2012; 150:503–515.

21. Perkins BA, Olaleye D, Bril V. Carpal tunnel syndrome in patients with diabetic polyneuropathy. Diabetes Care. 2002; 25:565–569.

22. Satman I, Yilmaz T, Sengül A, Salman S, Salman F, Uygur S, et al. Population-based study of diabetes and risk characteristics in Turkey: results of the turkish diabetes epidemiology study (TURDEP). Diabetes Care. 2002; 25:1551–1556.

23. Kurt S, Karaer H, Kaplan Y, Etikan İ. The relationship between carpal tunnel syndrome and body mass index, age and gender. Turk J Phys Med Rehab. 2006; 52:154–157.

24. Hlebs S, Majhenic K, Vidmar G. Body mass index and anthropometric characteristics of the hand as risk factors for carpal tunnel syndrome. Coll Antropol. 2014; 38:219–226.

25. Gundogan K, Bayram F, Gedik V, Kaya A, Karaman A, Demir O, et al. Metabolic syndrome prevalence according to ATP III and IDF criteria and related factors in Turkish adults. Arch Med Sci. 2013; 9:243–253.

26. Onat A, Yüksel M, Köroğlu B, Gümrükçüoğlu HA, Aydın M, Cakmak HA, et al. [Turkish Adult Risk Factor Study survey 2012: overall and coronary mortality and trends in the prevalence of metabolic syndrome]. Turk Kardiyol Dern Ars. 2013; 41:373–378.