ABSTRACT

Objective:

Carpal tunnel syndrome (CTS) is diagnosed by clinical findings, physical examination and electromyography (EMG). Body mass index (BMI) is an important risk factor in the development of CTS. Numerous factors such as diabetes, hypothyroidism, hormone replacement therapy and corticosteroid use cause carpal tunnel syndrome. Metabolic syndrome components have been reported as the causes of carpal tunnel syndrome. However, there are few studies on the relationship between CTS and metabolic syndrome. In this study, we aimed to reveal the relationship between metabolic syndrome and carpal tunnel syndrome.

Methods:

A total of 160 (30 male and 130 female) right-hand dominant patients, who were referred to our EMG laboratory with CTS pre-diagnosis and electrophysiologically diagnosis verification of CTS, were included in the study. Patients were divided into two groups as those with metabolic syndrome and those without metabolic syndrome, according to the 2005 International Diabetes Federation metabolic syndrome diagnosis criteria. Age, gender, dominant and affected hands, height, and weight of all patients were recorded. The relation between metabolic syndrome and CTS was statistically compared in patients grouped as mild, moderate and severe according to electrophysiological evaluation.

Results:

Mean age of the patients included in the study was 46.49±11.75 years, and 130 (81.3%) of them were female. Average BMI of all patients was 29.80±5.28. Of the patients, 58.8% (n=94) was diagnosed with metabolic syndrome. Metabolic syndrome was present in 83 (75.5%) out of 110 patients with electrophysiologically diagnosed CTS. Metabolic syndrome was found in 11 (22%) of 50 patients with no CTS electrophysiologically. A significant relationship was found between metabolic syndrome and CTS.

Conclusion:

As a result, the metabolic syndrome is higher in patients electrophysiologically diagnosed with CTS. In obese patients with CTS, the risk of having metabolic syndrome should be considered, and correct referral should be made in addition to the treatment that may be applied for CTS.

Keywords: Carpal tunnel syndrome, metabolic syndrome, body mass index

References

Şenel K. El ve El Bileği Ağrısı. ed: Beyazova M, Gökçe-Kutsal Y. Fiziksel Tıp ve Rehabilitasyon. Güneş Kitabevi Ltd Şti 2000;2:1455-64.

Wong S, Griffith J, Hui A, Tang A, Wong K. Discriminatory sonographic criteria for the diagnosis of carpal tunnel syndrome. Arthritis Rheum 2002;46:1914-21.

D’Arcy CA, McGee S. Does this patient have carpal tunnel syndrome? JAMA 2000;283:3110-7.

Tanaka S, Wild DK, Seligman PJ, Behrens V, Cameron L, Putz-Anderson V. The US prevalence of self-reported carpal tunnel syndrome. Am J Public Health 1994;84:1846-8.

Stevens JC. The electrodiagnosis of carpal tunnel syndrome. American Association of Electrodiagnostic Medicine. Muscle Nerve 1997;20:1477-86.

Burke DT, Burke MAM, Bell R, Stewart GW, Mehdi RS, Kim HJ. Subjective Swelling : A New Sign for Carpal Tunnel Syndrome. Am J Phys Med Rehabil 1999;78:504-8

Tüzün F, Ünalan H. Tuzak Nöropatileri. Elektroterapi, İ.Ü. Cerrahpaşa Tip Fak. FTR A.B.D. İstanbul 1999;1-5, 19-25.

Özel S, Öken Ö. Oğuz H, Dursun E, Dursun N (editörler). Periferik sinir lezyonları, Tıbbi Rehabilitasyon. Nobel Tıp Kitabevleri 2004:665-94.

Rengachary SS. ed: Wilkins RH, Rengachary SS. Neurosurgery International ed. The Mc,Graw-Hill Companies Entrapment neuropathies 1996:3073-98.

Ertekin C. Pleksus Brakiyalisten Çıkan Sinirler. Santral ve Periferik EMG Anatomi-Fizyoloji-Klinik. İzmir: Meta Basım Matbaacılık 2006:387-453.

Scoot MG, James IC. Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735-52.

Grundy SM. Metabolic syndrome: A growing clinical challenge. Medscape Cardiol 2004;8:1-12.

Onat A. TEKHARF 2017 Tıp Dünyasının Kronik Hastalıklara Yaklaşımına Öncülük. Edited by Altan ONAT. İstanbul: Logos Yayıncılık 2017:168.

Jablecki CK. Issues & Opinions: Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: Summary statement: American association of electrodiagnostic medicine, american academy of neurology, american academy of physical medicine and rehabilitation. Muscle Nerve 1993;16:1390-1.

Jablecki CK, Andary MT, So YT, Wilkins DE, Williams FH. Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. AAEM Quality Assurance Committee. Muscle Nerve 1993;16:1392-414.

Kulick RG. Carpal tunnel syndrome. Orthop Clin North Am 1996;27:345-54.

Kouyoumdjian JA, Zanetta DMT, Morita M. Evaluation of age, body mass index, and wrist index as risk factors for carpal tunnel syndrome severity. Muscle Nerve 2002;25:93-7.

Radecki P. Carpal tunnel syndrome: Effects of personal factors and associated medical conditions. Physical Medicine And Rehabilitation Clinics Of North America 1997;8:419-38.

Becker J, Nora DB, Gomes I, Stringari FF, Seitensus R, Panosso JS, et al. An evaluation of gender, obesity, age and diabetes mellitus as risk factors for carpal tunnel syndrome. Clinical Neurophysiology 2002;113:1429-34.

Fowler SB, Moussouttas M, Mancini B. Metabolic syndrome: Contributing factors and treatment strategies. Journal of Neuroscience Nursing 2005;37:220.

Lam N, Thurston A. Association of obesity, gender, age and occupation with carpal tunnel syndrome. Aust N Z J Surg 1998;68:190-3.

Mondelli M, Aprile I, Ballerini M, Ginanneschi F, Reale F, Romano C, et al. Sex differences in carpal tunnel syndrome: comparison of surgical and non‐surgical populations. Eur J Neurol 2005;12:976-8.

Stallings SP, Kasdan ML, Soergel TM, Corwin HM. A case-control study of obesity as a risk factor for carpal tunnel syndrome in a population of 600 patients presenting for independent medical examination. J Hand Surg Am 1997;22:211-5.

Tanaka S, Wild DK, Cameron LL, Freund E. Association of occupational and non‐occupational risk factors with the prevalence of self‐reported carpal tunnel syndrome in a national survey of the working population. AmJ Ind Med 1997;32:550-6.

Balci K, Utku U. Carpal tunnel syndrome and metabolic syndrome. Acta Neurol Scand 2007;116:113-7.

Aykaç S. Karpal tünel sendromu ile metabolik sendrom arasındaki ilişki. Taksim Eğitim Ve Araştırma Hastanesi Nöroloji Kliniği 2010:55-8.

Bagatur AE, Zorer G: The carpal tunnel syndrome is a bilateral disorder. J Bone Joint Surg Br 2001;83:655-8.

Bozkurt G. Periferik Sinir Tuzak Nöropatileri. Türk Nöroşirurji Dergisi 2005;15:206-19.

Gündüz OH, Yılmaz L, Bodur H. İleri Yaş Grubunda Elektrofizyolojik İncelemeler. Türk Geriatri Dergisi 2002;5:135-7.

Szabo RM, Madison M. Carpal tunnel syndrome. Orthop Clin North Am North Am 1992;23:103-9.

Padua L, LoMonaco M, Gregori B, Valente E, Padua R, Tonali P. Neurophysiological classification and sensitivity in 500 carpal tunnel syndrome hands. Acta Neurol Scand 1997;96:211-17.

Gündüz H, Borman P, Bodur H, Uçan H. Karpal tünel sendromlu hastalarda el bilek boyutları, klinik ve elektrodiagnostik özellikler. Türk Fiz Tıp Rehab Derg 2003;49:22-6.

Ertekin C. Santral ve Periferik EMG Anatomi-Fizyoloji-Klinik. İzmir: Meta Matbaacılık 2006:403-27.

Nadler SF, Schuler S, Nadler JS. Cumulative trauma disorders. In: Delisa JA. Physical Medicine & Rehabilitation Principles and Practice 2005:615-63.

Posch J, Marcotte D. Carpal tunnel syndrome: an analysis of 1201 cases. Orthop Rev 1976;5:25-35.

Oh SJ. Clinical electromyography. 2.baskı. USA: Williams & wilkins 1993:78-83,496-574.

Preston DC, Shapiro BE. Median neuropathy. Electromyography and Neuromuscular Disorders Clinical Electrophysiologic Correlations. 3rd Edition. 1998:235-64.

Kaymak B, Özçakar L. Karpal tünel sendromu. Hacettepe Tıp Dergisi 2007;38:141-6.

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) final report. Circulation 2002;106:3143-421.

Kozan O, Oguz A, Abaci A, Erol C, ngen Z, Temizhan A, et al. Prevalence of the metabolic syndrome among Turkish adults. Eur J Clin Nutr 2007;61:548-53.

Metabolik Sendrom araştırma grubu. METSAR Sonuçları. XX.Ulusal Kardiyoloji Kongresi. Antalya, 2004.

International Diabetes Federation. Worldwide definition of the metabolic syndrome. Available at: http://www.idf.org/webdata/docs/ IDF_Metasyndrome_ definition .pdf. Accessed August 24, 2005.

Kouyoumdjian JA, Morita MPA, Rocha PRF, Miranda RC, Gouveia G. Body mass index and carpal tunnel syndrome. Arq Neuropsiquiatr 2000;58:252-6.

Werner RA, Albers JW, Franzblau A, Armstrong TJ. The relationship between body mass index and the diagnosis of carpal tunnel syndrome. Muscle Nerve 1994;17:632-6.

Çolakoğlu MT, Özer H, Oğuz T, Solak Ş, Ağaoğlu S. Karpal Tünel Sendromlu Hastalarda Beden Kitle İndeksi Ve Şiddetin Değerlendirilmesi. Artroplasti Artroskopik Cerrahi 2004;15:81-4.

Relationship Between Carpal Tunnel Syndrome and Metabolic Syndrome

ABSTRACT

References