Modifiable and Non-Modifiable Predictors of Dupuytren’s Disease

Abstract

Dupuytren's disease (DD) is a common multifactorial disease accompanied by deformity of the hand with flexion contracture of one or more fingers, limitation of their mobility and a fixed lesion. This disease refers to disorders of the connective tissue. Objective: to generalize the results of studies of environmental risk factors for DD and update existing ideas about modifiable and non-modifiable predictors of the disease in adults. Methods. We searched for full-text English-language publications in the PubMed, Springer, Scopus, Clinical Keys, Oxford Press, Google Scholar, eLIBRARY. Results. The most significant modifiable predictors of the development of DD include (top 5): occupation; hobby; lifestyle; comorbid diseases; drugs. Non-modifiable predictors include (top 5): gender; age; ethnos; race; genetics. Genetic predictors of DD are not well understood, but the number of candidate genes responsible for the development of DD is increasing and reaches the top 50 or more candidate genes with a statistically significant association with the risk of developing DD in adults. The most studied candidate genes are DUPC1, MMP2, MMP9, TIMP1, TIMP2, WNT4, WNT7B. Discussion. Primary and secondary prevention of DD requires accounting of the mutual influence of modifiable and non-modifiable predictors in the disease development, as well as a personalized approach in planning and choosing non-surgical and surgical treatment, as well as the carriage of single nucleotide variants (SNVs) candidate genes associated with the development of DD. A promising direction in the prevention of disabling complications of DD may be the development of decision-making information programs (personalized algorithms) that take into account non-genetic and genetic predictors in a particular person, and their implementation in real clinical practice. Conclusion. Large multicenteral studies of the influence and mutual influence of modifiable and non-modifiable predictors with a single design are required in the future.