Relationship of Age, Body Mass Index, Wrist and Waist Circumferences to Carpal Tunnel Syndrome Severity

Abstract

Carpal tunnel syndrome (CTS) has a multifactorial etiology involving systemic, anatomical, idiopathic, and ergonomic characteristics. In this study, an investigation of the relationship between the CTS degree established by electrophysiological measurements in patients with clinical CTS prediagnosis, and age, gender, body mass index (BMI), hand wrist circumference, and waist circumference measurements has been done. On 547 patients included in the study, motor and sensory conduction examinations of the median and ulnar nerve were done on one or two upper extremities thought to have CTS. In terms of CTS severity, the patients were divided into four groups (normal, mild, medium, and severe CTS). A total of 843 electrophysiological examinations were done consisting of 424 on the right hand wrist and 419 on the left hand wrist. When the age group of 18-35 years is taken as the reference group, the CTS development risk independent of BMI has been found to have increased by a factor of 1.86 for ages 36-64 years, and by 4.17 for ages 65 years and higher after adjustment for BMI. With respect to normal degree CTS group, the BMI were significantly different in groups with mild, medium, and severe CTS. The waist circumferences of groups with mild, medium, and severe CTS severity were found to be significantly higher in comparison to the normal reference group. When this value was corrected with BMI and re-examined the statistically significant differences persisted. The study identified a significant relationship between the CTS severity and age, BMI, waist circumference.

Association Between Cardiovascular Risk Factors and Carpal Tunnel Syndrome in Pooled Occupational Cohorts

“…27 Waist circumference was also identified as an independent risk in another study that also found a relationship with electrodiagnostic severity of CTS. 36 There are numerous other reported risk factors such as diabetes mellitus (DM). 3,[21][22][23][24][25] Fewer studies have assessed risk from metabolic syndrome, although it also is reportedly a risk.…”

Associations Between Body Anthropometric Measures and Severity of Carpal Tunnel Syndrome

“…Previous literature data showed a direct relation of slowed SCV and DML of the median nerve (or the stage of CTS electrophysiological severity) with the values of some ratios of the hand/wrist (hand ratio and wrist ratio). [8][9][10]12,14,19,32,51 On the contrary, other authors did not find any relation between the wrist ratio and electrophysiological CTS severity or DML and SCV of the median nerve in patients with CTS 15,52 and in those without CTS. 53 In the carpal tunnel, the median nerve is subjected to various mechanical stresses related to different postures and movements of the fingers and wrist.…”

“…[26][27][28][29] There are very few studies in the literature on WC and only one on waist/hip ratio in CTS. [30][31][32] The absolute value of WC may have limited usefulness if it is not corrected for the hip circumference and stature of the subjects. We recently demonstrated that a large WC and especially a high waist/hip ratio double the risk of CTS regardless of the value of BMI, and the risk is further increased if subjects who are overweight and obese also have a very large WC or high waist/hip ratio.…”

“…33 Many studies published up until now did not take the new obesity indicators into account, evaluated few body or hand and wrist measurements at a time, and often had limited statistical power because they used only linear models with univariate analysis. 17,[22][23][24]32,[34][35][36] Only a few studies performed multivariate analysis. 12,[14][15][16]25 Furthermore, some studies had a small sample size, 12,23,25,34 lacked a well-matched control group, 32,34,36 and were limited to women.…”

“…17,[22][23][24]32,[34][35][36] Only a few studies performed multivariate analysis. 12,[14][15][16]25 Furthermore, some studies had a small sample size, 12,23,25,34 lacked a well-matched control group, 32,34,36 and were limited to women. 12,36 To our knowledge, there are no studies that analyzed the anthropometric factors all together, including the new obesity indicators, using tests with high statistical power in a large sample.…”