Carpal tunnel syndrome and metabolic syndrome

Abstract

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Many factors such as diabetes mellitus, hypothyroidism, hormonal replacement therapy, corticosteroid use, rheumatoid arthritis and wrist fractures may cause CTS. Metabolic syndrome includes abdominal obesity, dyslipidemia, hyperglycemia, and hypertension that may cause CTS. In this study, we aimed to evaluate the relation between CTS and metabolic syndrome. We studied 107 (96 female and 11 male) right-handed patients who had a clinical and electrophysiologically confirmed diagnosis of CTS. We then divided the patients into two groups (patients with and without metabolic syndrome) according to the criteria of ATP III definition. Eighty (75%) of the patients with CTS had metabolic syndrome. Among the 80 patients with metabolic syndrome, CTS was found in 150 hands (43 mild, 58 moderate and 49 severe cases). Among the 27 patients without metabolic syndrome, CTS was found in 43 hands (27 mild, 14 moderate and 2 severe cases). The electrophysiological parameters (median nerve distal motor latency, median nerve motor amplitude, median nerve motor conduction velocity, median nerve sensory onset latency, median nerve sensory amplitude and median nerve sensory conduction velocity) were worse in patients with metabolic syndrome (P < 0.05). In conclusion, metabolic syndrome was found to be three times more common in patients with CTS and CTS was more severe in patients with metabolic syndrome when compared with those without metabolic syndrome.

Outcome after carpal tunnel release: impact of factors related to metabolic syndrome

“…A high prevalence of metabolic syndrome has been found in patients with CTS, but the mechanisms behind this are not fully understood [24,25]. The current hypothesis is that the metabolic syndrome, and its individual components, is important for the onset and progression of peripheral neuropathy [6], where the underlying mechanisms, including fatty deposition in nerves, extracellular protein glycation, mitochondrial dysfunction, oxidative stress and counter-regulating signaling pathways leading to inflammation, may be different in 13 type 1 and 2 diabetes [6].…”

Ultrasound evaluation on carpal tunnel syndrome before and after bariatric surgery

“…It can therefore be concluded that obesity is associated with CTS, but weight loss in bariatric surgery is not sufficient to improve its repercussions in daily life. The higher prevalence of CTS in obese individuals is already well known in the literature [6][7][8][9][10][11][12][13] . Similarly, Moghtaderi et al 8 conducted a case-control study examining risk factors for CTS and demonstrated that BMI, age and anthropometric data of the wrist were higher in patients with CTS than in controls.…”

“…The most widely accepted theories for CTS ethiopathology are the mechanical and the microvascular nerve damage 2 . Many authors considered obesity as a predisposing factor [6][7][8][9][10][11][12][13] , as it may be associated to the mechanical theory when the fat tissue causes nerve root compression and raises local hydrostatic pressure 10,12 . However, microvascular insufficiency secondary to atherosclerosis, which is more common in the obese population 13 , may also play a role.…”

Increased pulse wave velocity and carotid intima–media thickness in patients with carpal tunnel syndrome

“…In addition, similar to our study, median nerve parameters were worse in patients with metabolic syndrome, implying advanced disease. 16 The pathophysiology of CTS involves different mechanisms. Elevated carpal tunnel pressure is the main pathology, causing mechanical compression and local ischemia.…”