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

Abstract

Background and PurposeCarpal 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.MethodsTwo 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).ResultsCTS 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.ConclusionsCTS 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.

The effect of metabolic syndrome on recurrence in patients who had undergone surgery for carpal tunnel syndrome

“…The CTS incidence peaks at a mean age of 40-60 years. [3] In a study by Yurdakul et al, [2] the mean age was 46.3±12.2 years, and 85.7% of the patients were female. Similarly, in the current study, CTS was observed 75.6% in females; however, the mean age of our patients was higher than the prior study (52.0±8.2 years) and its lead to high recurrence rate for the one reason.…”

“…[1] Although the etiology of CTS is not fully known, risk factors, such as repetitive use of the wrist, advanced age, obesity, pregnancy, acromegaly, trauma, amyloidosis, diabetes mellitus (DM), kidney disease, thyroid disease and osteoarthritis were reported to be responsible. [2] Carpal tunnel syndrome is most frequently observed in the age range of 40 to 74 years, and the general prevalence in the population is 2.7 to 5.8%. [3] However, CTS is observed at rates that are 10-fold higher in females than in males.…”

“…[4] The diagnosis of CTS is established based on patient history, clinical signs and findings from electrodiagnostic test. [2,4] The most common specific clinical signs of CTS are nighttime pain in the first three fingers, paresthetic complaints, such as burning, stinging and numbness, and weakness and itching in the palm of the hand. [3] Pain may be reflected in the arm and shoulder.…”

“…[6] The rates of recurrence after CTS surgery vary from 3 to 20%. [2] Metabolic syndrome (MS) is a disorder that combines insulin resistance, impaired glucose tolerance, DM, abdominal obesity, dyslipidemia and hypertension (HT). [2] Metabolic syndrome causes damage to the median nerve due to ischemic injury.…”

“…[2] Metabolic syndrome (MS) is a disorder that combines insulin resistance, impaired glucose tolerance, DM, abdominal obesity, dyslipidemia and hypertension (HT). [2] Metabolic syndrome causes damage to the median nerve due to ischemic injury. The frequency of CTS in patients with MS is three times higher than in those without MS. [7] Hence, in this study, we aimed to investigate whether or not MS affects recurrence in patients who had undergone surgery for CTS.…”