Association Between Diabetes Mellitus and Carpal Tunnel Syndrome: Results From the United States National Ambulatory Medical Care Survey

Low, Jason; Kong, Adrian C.; Castro, Grettel; Vega, Pura Rodriguez de la; Lozano, Juan Manuel; Varella, Marcia

doi:10.7759/cureus.13844

Cited by 9 publications

(8 citation statements)

References 13 publications

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“…In pervious large cohort studies, the prevalence of DM in patients with CTS ranged from 3 to 5% 18 – 20 . In one retrospective cohort study in USA, among 1,795 patients with CTS, 254 patients (15%) were diagnosed with DM 21 . The CTS patients combined with DM have been reported as up be to 21% of all CTS patients in a prospective ultrasonographic and electrophysiologic study 2 , which is consistent with our finding.…”

Section: Discussionmentioning

confidence: 99%

Effects of diabetes mellitus on the rate of carpal tunnel release in patients with carpal tunnel syndrome

Shin

Kim

Lee

et al. 2021

Sci Rep

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The objective of this study was to evaluate the effects of diabetes mellitus (DM) on the rate of carpal tunnel release (CTR) using a large nationwide cohort in Korea and to identify risk factors, including comorbidities and socioeconomic status (SES), associated with CTR. Patients with a primary or secondary diagnosis of carpal tunnel syndrome (CTS; ICD-10 code: G560) were selected and divided into two groups according to the presence of DM. A Cox proportional hazard model was used to assess the rate of CTR between the two groups. To evaluate the influence of demographic factors, comorbidities, and SES on CTR, multivariate Cox proportional hazard regression models were used to adjust for confounding variables. In total, 12,419 patients with CTS were included in the study: 2487 in DM cohort and 9932 in non-DM cohort. DM duration was negatively related with the rate of CTR (HR = 0.89, 95% CI 0.87–0.91) in CTS patients with DM. The rate of CTR was decreased in patients with DM compared to those without DM in the unadjusted model; however, after adjusting for comorbidities, DM had no significant effect on the rate of CTR. Female sex (HR = 1.50, 95% CI 1.36–1.67) correlated with the rate of CTR, and an inverse relationship between the number of comorbidities and CTR was found (p < 0.001) irrespective of DM. Diabetic polyneuropathy (DPN) was not associated with CTR, and we did not find any factors correlating with CTR in DPN patients. We found that CTS patients with more comorbidities or combined with a longer duration of DM were undertreated in real-word practice. Actual outcomes of CTR in CTS patents with various comorbidities should be investigated in future studies for optimal management of CTS.

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Section: Discussionmentioning

confidence: 99%

Effects of diabetes mellitus on the rate of carpal tunnel release in patients with carpal tunnel syndrome

Shin

Kim

Lee

et al. 2021

Sci Rep

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“…Of these, 22 reports were excluded with reasons ( Figure 1 ). Finally, 31 studies, consisting of 13 cross-sectional studies [ 10 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ], 10 case-control studies [ 11 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ], and 8 cohort studies [ 22 , 24 , 25 , 26 , 27 , 55 , 56 , 57 ], were included in the meta-analysis. The characteristics and quality of the included studies are reported in Appendix A Table A2 , Table A3 and Table A4 .…”

Section: Resultsmentioning

confidence: 99%

Is Smoking Associated with Carpal Tunnel Syndrome? A Meta-Analysis

et al. 2022

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To date, the role of smoking in carpal tunnel syndrome (CTS) is unclear. The aim of this systematic review and meta-analysis was to assess the association between smoking and CTS. The literature searches were conducted in PubMed, Embase, and Scopus, from inception until October 2021. Three reviewers screened the titles, abstracts, and full-text articles and evaluated the methodological quality of the included studies. A random-effects meta-analysis was used, and heterogeneity across studies was examined using I2 statistic. A total of 31 (13 cross-sectional, 10 case-control, and 8 cohort) studies were qualified for meta-analysis. In a meta-analysis of cohort studies, the risk of CTS did not differ between current and never smokers (pooled hazard ratio (HR) 1.09, 95% CI 0.84–1.43), current and past/never smokers (HR 1.07, 95% CI 0.94–1.23), and past and never smokers (HR 1.12, 95% CI 0.83–1.49). Furthermore, a meta-analysis of case control studies found no difference in the risk of CTS between current and never smokers (pooled odds ratio (OR) 0.92, 95% CI 0.56–1.53), current and past/never smokers (OR 1.10, 95% CI 0.51–2.36), and past and never smokers (OR 0.91, 95% CI 0.59–1.39). However, a meta-analysis of cross-sectional studies showed the associations of ever (OR 1.36, 95% CI 1.08–1.72) and current smoking (OR 1.52, 95% CI 1.11–2.09) with CTS. However, the association between ever smoking and CTS disappeared after limiting the meta-analysis to higher quality studies or after adjusting for publication bias. The association between current smoking and CTS also attenuated after limiting the meta-analysis to studies that confirmed CTS by a nerve conduction study or studies with low attrition bias. This meta-analysis does not support an association between smoking and CTS. The association between smoking and CTS observed in cross-sectional studies could be due to biases and/or confounding factors.

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“…Diabetes mellitus (DM) was not found to be associated with bilateral CTS. Interestingly, recent epidemiological studies also found no significant association between DM and CTS [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictive factors for bilateral carpal tunnel syndrome by electrodiagnosis: A retrospective study

2021

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Introduction Carpal tunnel syndrome (CTS) is the most common compressive neuropathy. Patients who have unilateral symptoms are frequently found to have bilateral CTS by electrodiagnostic (EDx) study. We aimed to (a) study the prevalence and identify the predictive factors for bilateral CTS diagnosed by EDx; and (b) develop a model to predict bilateral CTS. Methods The retrospective clinical and EDx data of patients with CTS were collected and analyzed using the Chi-squared test and multiple logistic regression analysis. A model was fitted, and the best cutoff point determined. Calibration and discrimination performance of the model were performed. Results A total of 327 patients with a mean age of 50.0 years were enrolled. Most were women (82.6%), and the most common presenting symptom was hand numbness (93.6%). The median duration of symptoms was 60 days. The prevalence of bilateral CTS was 80.7%. In the multivariate analysis, the predictive factors for bilateral CTS were the presence of bilateral symptoms (AOR 6.7 [95%CI 3.1–14.3]), thenar muscle weakness (AOR 3.9 [95%CI 1.3–11.6]), and age ≥ 45 years (AOR 2.5 [95%CI 1.3–4.6]). The logistic regression model was fitted, and the best cutoff point determined. The area under the receiver operating curve (AUC) was 0.76. The respective optimism-corrected C index and Somers’ D was 0.762 and 0.524. Conclusion The prevalence of bilateral CTS was 80.7%. Our findings suggest bilateral CTS was predicted with adequate diagnostic accuracy by bilateral symptoms, age ≥ 45 years, and thenar muscle weakness.

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Association Between Diabetes Mellitus and Carpal Tunnel Syndrome: Results From the United States National Ambulatory Medical Care Survey

Cited by 9 publications

References 13 publications

Effects of diabetes mellitus on the rate of carpal tunnel release in patients with carpal tunnel syndrome

Effects of diabetes mellitus on the rate of carpal tunnel release in patients with carpal tunnel syndrome

Is Smoking Associated with Carpal Tunnel Syndrome? A Meta-Analysis

Prevalence and predictive factors for bilateral carpal tunnel syndrome by electrodiagnosis: A retrospective study

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