Could be B12 vitamin deficiency a risk factor in carpal tunnel syndrome?

Year 2019, , 73 - 77, 01.05.2019

Mehmet Mühürdaroğlu , Ezgi Agadayı

https://doi.org/10.5505/abantmedj.2019.82642

Abstract

INTRODUCTION: To determine whether serum vitamin B12 levels have an effect on CTS carpal tunnel syndrome and grade of electrophysiological factors in patients with carpal tunnel syndrome.METHODS: A total of 158 patients were included in the study. 77 CTS and 81 non detected CTS patients’ vitamin B12 levels were retrospectively determined. Data were analyzed with Shapiro Wilk, Kruskal Wallis and Chi-Square statistic tests.RESULTS: When the vitamin B12 levels of the patients were examined, deficiency was detected in 22.8% n=36 patients and normal in 77.2% n=122 patients. Vitamin B12 deficiency was found in 12.7% n=20 of the patients with CTS while 36.1% n=77 were not detected. There was no significant difference between the patients with CTS and those who were not detected as compared to B12 vitamin deficiency p = 0.351 .DISCUSSION AND CONCLUSION: Although it was not statistically significant, vitamin B12 deficiency was significantly more pronounced in patients with severe CTS. This supports the use of vitamin B12 in treatment CTS. Our study should be supported by studies with a larger number of cases.

Keywords

deficiency, etiologyCarpal tunnel syndrome, vitamin B12

Karpal tünel sendromunda B12 vitamin eksikliği risk faktörü olabilir mi?

Abstract

GİRİŞ ve AMAÇ: Karpal tünel sendromu şikayetleri olan hastalarda serum B12 vitamin düzeyinin elektrofizyolojik olarak KTS karpal tünel sendromu ve derecesi üzerine etkisi olup olmadığını saptamaktır.YÖNTEM ve GEREÇLER: Çalışmaya toplam 158 hasta dahil edildi. 77 KTS ve 81 tane elekfizyolojik olarak KTS saptanmayana hastanın B12 vitamin seviyeleri retrospektif olarak incelendi. Verilerin istatistiksel analizinde Shapiro Wilk, Kruskal Wallis ve Ki-Kare testleri kullanıldı. BULGULAR: Hastaların B12 vitamini düzeylerine bakıldığında %22,8’inde n=36 eksiklik tespit edilirken, %77,2’sinde n=122 normal olarak saptandı. KTS saptanan hastaların %12,7’sinde n=20 B12 vitamin eksikliği saptanırken, %36,1’inde n=77 saptanmadı. Elektrofizyolojik olarak KTS saptananlar ile saptanmayanlar arasında B12 vitamin eksikliği karşılaştırıldığında anlamlı fark saptanmamıştır p=0,351 . TARTIŞMA ve SONUÇ: İstatiksel olarak anlamlı olmasa da KTS saptanan hastalardaki B12 vitamin eksikliği özellikle ağır KTS olan hastalarda daha belirgindi. Bu da tedavide B12 vitamini kullanımını destelemektedir. Çalışmamızın daha geniş olgu sayısına sahip çalışmalarla desteklenmesi gereklidir.

Keywords

Karpal tünel sendromu, B12 vitamin eksikliği, etyoloji

References

• Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I. Prevalence of Carpal Tunnel Syndrome in a General Population. JAMA 1999; 282: 153-8.
• de Krom MC, Kester AD, Knipschild PG, Spaans F. Risk Factors for Carpal Tunnel Syndrome. Am J Epidemiol 1990; 132: 1102-10.
• Stevens JC, Witt JC, Smith BE, Weaver AL. The Frequency of Carpal Tunnel Syndrome in Computer Users at a Medical Facility. Neurology 2001; 56: 1568-70.
• Stevens JC, Sun S, Beard CM, O'Fallon WM, Kurland LT. Carpal Tunnel Syndrome in Rochester, Minnesota, 1961 to 1980. Neurology 1988; 38: 134-8.
• de Krom MC, Knipschild PG, Kester AD, Thijs CT, Boekkooi PF, Spaans F. Carpal Tunnel Syndrome: Prevalence in the General Population. J Clin Epidemiol 1992; 45: 373-6.
• Eroğlu M, Er MS, Altınel L, Eroğlu S, Çetinkaya G. Assessment of Frequency and Severity of Clinical Findings Related to Carpal Tunnel Syndrome in Patients Undergoing Hemodialysis Therapy. Abant Med J 2014; 3(3): 210-4.
• Weiss L, Silver JK, Weiss J. Easy EMG. Çeviri: Beyazova M. Kolay EMG. Güneş Tıp Kitabevi, Ankara 2010: 121-5.
• So YT: Deficiency Diseases of the Nervous System, In: Jankovic J, Mazziotta J, Pomeroy S, Dar R: Bradley's Neurology in Clinical Practice. 7th Edition, Elsevier 2015: 1226-37.
• Briani C, Torre CD, Citton V, Manara R, Pompanin S, Binotto G, Adami F, Review Cobalamin Deficiency: Clinical Picture and Radiological Findings. Nutrients 2013; 5: 4521- 39.
• Botez MI, Peyronnard JM, Charron L. Polyneuropathies Responsive to Folic Acid Therapy. In: Botez MI, Reynolds EH, eds. Folic Acid in Neurology, Psychiatry and Internal Medicine. Raven Press, New York 1979: 401-12.
• Shorvon SD, Reynolds EH. Folate Deficiency and Peripheral Neuropathy. In: Botez MI, Reynolds EH, eds. Folic acid in Neurology, Psychiatry and Internal Medicine. Raven Press, New York 1979: 413-421.
• Keskin A. Megaloblastik Anemi. Türkiye Klinikleri Aile Hekimliği Özel Konular, 2016; 7(3): 70-3.
• TEMD Tiroid Hastalıkları Çalışma Grubu: Tiroid Hastalıkları Tanı ve Tedavi Kılavuzu 2017. Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş, Ankara 2017.
• Türk Hematoloji Derneği: I. Bölüm B12 Vitamini Eksikliği Tanı Ve Tedavi Kılavuzu, In: Ulusal Tedavi Kılavuzu 2011.
• World Health Organization: Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity, In: Vitamin and Mineral Nutrition Information System. World Health Organization, Geneva 2011: 6.
• Warner EA, Herold AH: Interpreting Laboratory Tests, In: Rakel RE, Rakel DP: Textbook of Family Medicine. 8th Edition, Elsevier Saunders, Philadelphia 2011; 187.
• Negrão L, Nunes P, on behalf of the Portuguese Group for the Study of Peripheral Neuropathy. Uridine Monophosphate, Folic Acid and Vitamin B12 in Patients with Symptomatic Peripheral Entrapment Neuropathies. Pain Manag 2016; 6(1): 25–9.
• Biçer M, Çabalar M, Ecerkale Ö. Karpal Tünel Sendromu Tedavisinde B Vitamini İle Tendon-Sinir Germe Egzersizlerinin Klinik ve Elektrofizyolojik Parametrelere Etkisi. İstanbul Tıp Dergisi 2014; 15: 16-20.
• Tanaka H. Old or New Medicine? Vitamin B12 and Peripheral Nerve Neuropathy. Brain Nerve. 2013; 65(9): 1077-82.