The evaluation of vitamin D levels in patients with carpal tunnel syndrome

Shehta

Egypt J Neurol Psychiatry Neurosurg

et al. 2018

BackgroundCarpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity. The aim of this study is to evaluate the body mass index (BMI) and vitamin D levels in CTS patients.MethodsThe current study was conducted at Zagazig University Hospitals. It included 50 CTS patients and 50 controls. Clinical assessment was carried out to exclude symptoms and signs of neuropathy. Laboratory investigations including vitamin D levels, glycosylated hemoglobin, liver, and kidney function were carried out for every participant. All patients underwent electrodiagnostic study and completed Boston questionnaire to assess their pain sum score, symptom severity (SSS), and functional status (FSS).ResultsPatients had significantly higher BMI and lower vitamin D levels compared to controls (p = 0.003 and p = 0.001, respectively). Those with severe CTS had a significantly higher BMI and lower vitamin D levels than the others (p = 0.03 and p = 0.01 respectively). No significant difference was found between CTS subgroups regarding the SSS, while a higher significant FSS and pain sum score were reported in the severe CTS patients compared to the other two groups (p = 0.01 and p = 0.04 respectively). A significant negative correlation was detected between vitamin D levels and both of BMI, and Boston pain sum scores (p = 0.01 and p = 0.03 respectively). Also, an inverse correlation was detected between vitamin D levels and both of SSS and FSS (p = 0.14, p = 0.06). Furthermore, a significant positive and negative correlation between vitamin D levels and both of conduction velocity and distal motor latency respectively was observed (p = 0.02 and p = 0.01 respectively).ConclusionsCarpal tunnel syndrome was significantly associated with hypovitaminosis D especially in patients with higher BMI. This highlights the importance of vitamin D supplements and weight loss regimes to minimize the severity of their pain.

Section: Discussioncontrasting

confidence: 84%

“…This observation was in agreement with recent studies (Tanik et al 2016 ). Similarly, in their study, Gursoy et al ( 2016 ) observed significantly low vitamin D level in patients with CTS compared to controls.…”

Section: Discussionmentioning

confidence: 56%

Body mass index and vitamin D level in carpal tunnel syndrome patients

Shehta

Egypt J Neurol Psychiatry Neurosurg

et al. 2018

“…CTS patients had significantly lower vitamin D levels compared with the controls. This observation was in agreement with previously published studies from Tanik et al (4), Nageeb et al (5) and Gürsoy et al (26). In contrast, Lee et al (27) showed there was no difference in vitamin D levels between the patients with CTS and the controls.…”

Section: Discussionsupporting

confidence: 93%

Carpel tunnel syndrome: A link with vitamin D and calcium

Abdul‐Razzak

Kofahi

2020

biom rep

Carpal tunnel syndrome (CTS) and vitamin D deficiency are two conditions that cause chronic pain and are thus associated with psychological issues as well. The aim of the present study was to evaluate vitamin D levels, daily calcium intake, musculoskeletal pain and psychological symptoms in patients with CTS. The study included 48 patients with CTS and age-sex matched controls. Serum vitamin D levels were measured, and psychological symptoms were assessed using a Hospital Anxiety and Depression Scale. A Pain DETECT questionnaire was used to assess musculoskeletal pain (MSP) sites and severity. The results showed that vitamin D deficiency was considerably more prevalent in patients with CTS (95.8%) compared with controls (22.9%). Clinical anxiety (35.4 vs. 6.3%) and clinical depression (29.2 vs. 4.2%) were also more common in patients with CTS compared with controls. All the patients with CTS exhibited MSP, whereas none of the controls reported any MSP. Anxiety was significantly and inversely associated with vitamin D levels (r 2 =-0.482; P<0.01), total daily calcium intake (r 2 =-0.294: P<0.05), and positively associated with body mass index (BMI; r 2 =0.200; P≤0.05) and depression (r 2 =0.587; P<0.01). Depression was significantly and inversely associated with vitamin D levels (r 2 =-0.269; P<0.01) and total daily calcium intake (r 2 =-0.236; P<0.05). Logistic regression analysis showed that with every unit increase in serum vitamin D levels, the odds of CTS were decreased 1.22x. While a one-unit increase in anxiety total score was associated with a 14% increase in the odds of having CTS after adjusting for different confounders. In conclusion, vitamin D deficiency, MSP and psychological symptoms are common in patients with CTS. Serum vitamin D levels and anxiety were significant independent predictors of CTS. Based on the results of the present study, it was shown that housewives had an equivalent chance of suffering from CTS morbidity as other high-risk professions. Further studies are required to confirm if vitamin D supplementation could prevent the onset of CTS.

“…However, a separate study involving the use of Boston Carpal Tunnel Questionnaire to assess symptom severity did not find an association between vitamin D level and pain symptoms and functional status [23]. In the current study, vitamin D was statistically significantly lower in the patient group versus control group.…”

Section: Discussionmentioning

confidence: 46%

The impact of serum vitamin D concentration on median nerve conduction

Özer

2018

J Clin Exp Invest

Objectives:To perform nerve conduction studies (NCS) and to evaluate distal latency, amplitude and conduction velocity values of the median nerve in relation to serum vitamin D levels in patients with neuropathic symptoms compared to controls. Patients and Methods:Patients with neuropathic symptoms of numbness, tingling and burning sensation were included in the study. Serum 1,25(OH) D3 levels were measured and patients were stratified by vitamin D status into three subgroups. Electrophysiological assessments of the median nerve were performed as recommended by the American Society of Electrodiagnostic Medicine. SPSS for Windows, version 24 was used for statistical analyses. Median nerve conduction values were compared between patient and control groups in relation to vitamin D concentration. Results:The study enrolled 39 patients including 24 (61.5%) males and 15 (38.5%) females and 39 control subjects including 22 (56.4%) males 17 (43.6%) females. Patient and control groups had a mean age of 45 years. Average vitamin D concentration was 8.5 ng/ml in the patient group and 8.8 ng/ml in the control group. There was no statistically significant difference between two groups with respect to age and average vitamin D concentration (p=0.552). Greater distal latency values and a statistically significant association between median nerve distal latency and vitamin D deficiency were found in the vitamin D-deficient subgroup (p=0.024). Conclusion: Given the neuroprotective action of vitamin D and the involvement of vitamin D deficiency in several neurological diseases as well as evidence that it might be an independent risk factor and a potential biomarker for neuropathy, we believe that patients presenting with mononeuropathy or polyneuropathy to a healthcare facility should be screened for vitamin D deficiency.