Are body mass index and the systemic immune-inflammation index risk factors for carpal tunnel syndrome?

Yıl 2023, Cilt: 9 Sayı: 3, 468 - 476, 04.05.2023

Meltem Karacan Gölen Dilek Yılmaz Okuyan

https://doi.org/10.18621/eurj.1120577

Öz

Objectives: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity that affects activities of daily living. In our study, we aimed to reveal the relationship between CTS and BMI, and to evaluate symptom severity and functionality in these patients by using the Boston CTS questionnaire.

Methods: In this study, 300 patients with CTS and 100 healthy individuals without CTS whose EMG was performed in our neurology clinic electrophysiology laboratory between June 2021 and December 2021, were included. BMI, SII index, and Boston CTS questionnaire findings were compared between patients diagnosed as having mild, moderate, and severe CTS (according to electrophysiologic evaluations) and a control group consisting of healthy individuals.

Results: In our study, a statistically significant difference was observed between the CTS and control groups in terms of mean age (p < 0.001). When the increased BMI and SII parameters were compared, a statistically significant difference was observed between the control and CTS groups (p < 0.001 for both). In the multivariate logistic regression analysis, it was observed that the risk of CTS increased 1.566 times as BMI increased, and the risk of CTS increased 1.005 times as the SII index increased (p < 0.001 for both).

Conclusions: We observed that increased BMI and advanced age were risk factors for CTS. In our study, in which the relationship between the SII index and CTS was evaluated for the first time, according to our findings, inflammation was thought to play a role in the pathophysiology of CTS.

Anahtar Kelimeler

Carpal tunnel syndrome, body mass index, nerve conduction study, inflammation, systemic immune-inflammation index

Kaynakça

• 1. Miyamoto H, Morizaki Y, Kashiyama T, Tanaka S. Grey-scale sonography and sonoelastography for diagnosing carpal tunnel syndrome. World J Radiol 2016;8:281-7.
• 2. Kurt S, Karaer H, Kaplan Y, Etikan İ et al. [The relationship between carpal tunnel syndrome and body mass index, age and gender]. Turk J Phys Med Rehab 2006;52:154-7. [Article in Turkish]
• 3. Newington L, Harris EC, Walker-Bone K. Carpal tunnel syndrome and work. Best Pract Res Clin Rheumatol 2015;29:440-53.
• 4. Cranford CS, Ho JY, Kalainov DM, Hartigan BJ. Carpal tunnel syndrome. J Am Acad Orthop Surg 2007;15:537-48.
• 5. Neal NC, McManners J, Stirling GA. Pathology of the flexor tendon sheath in the spontaneous carpal tunnel syndrome. J Hand Surg Br 1987;12:229-32.
• 6. Yang Y, Han Y, Sun W, Zhang Y. Increased systemic immune-inflammation index predicts hemorrhagic transformation in anterior circulation acute ischemic stroke due to large-artery atherosclerotic. Int J Neurosci 2021. doi: 10.1080/00207454.2021.1953021.
• 7. Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res 2014;20:6212-22.
• 8. Habib SS, Alanazy MH. Predictive value of markers of adiposity in carpal tunnel syndrome: a clinical and electrophysiological evaluation. J Coll Physicians Surg Pak 2020;30:828-32.
• 9. Werner RA, Albers JW, Franzblau A, Armstrong TJ.. The relationship between body mass index and the diagnosis of carpal tunnel syndrome. Muscle and Nerve 1994;17:632-6.
• 10. Lee DH, Claussen GC, Oh S. Clinical nerve conduction and needle electromyography studies. J Am Acad Orthop Surg 2004;12:276-87.
• 11. Padua L, LoMonaco M, Gregori B, Valente EM, Padua R, Tonali P. Neurophysiological classification and sensitivity in 500 carpal tunnel syndrome hands. Acta Neurol Scand 1997;96:211-7.
• 12. Garrow JS, Webster J. Quetelet’s index (W/H2) as a measure of fatness. Int J Obes 1985;9:147-53.
• 13. Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, et al. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am 1993;75:1585-92.
• 14. Sezgin M, İncel NA, Sevim S, Camdeviren H, As İ, Erdogan C. Assessment of symptom severity and functional status in patients with carpal tunnel syndrome: reliability and validity of the Turkish version of the Boston Questionnaire. Disabil Rehabil 2006;28:1281-5.
• 15. Kouyoumdjian JA. Carpal tunnel syndrome. Age, nerve conduction severity and duration of symptomatology. Arq Neuropsiquiatr 1999;57:382-6.
• 16. Kommalage M, Pathirana KD. Influence of age and the severity of median nerve compression on forearm median motor conduction velocity in carpal tunnel syndrome. J Clin Neurophysiol 2011;28:642-6.
• 17. Becker J, Nora DB, Gomes I, Stringari FF, Seitensus Panosso JS, et al. An evaluation of gender, obesity, age and diabetes mellitus as risk factors for carpal tunnel syndrome. Clin Neurophysiol 2002;13:1429-34.
• 18. Vessey MP, Villard-Mackintosh L, Yeates D. Epidemiology of carpal tunnel syndrome in women of childbearing age. Findings in a large cohort study. Int J Epidemiol 1990;19:655-9.
• 19. Uzar E, İlhan A, Ersoy A. [Association between carpal tunnel syndrome and abdominal obesity]. Turk J Neurol 2010;16:187-92. [Article in Turkish]
• 20. Aydemir ŞU, Tekeşin A, Yıldırım A. [Relationship between carpal tunnel syndrome and metabolic syndrome]. Bakırköy Tıp Dergisi 2019;15:250-8. [Article in Turkish]
• 21. Kouyoumdjian JA, Zanetta DMT, Morita MP. Evaluation of age, body mass index, and wrist index as risk factors for carpal tunnel syndrome severity. Muscle Nerve 2002;25:93-7.
• 22. Altun Y, Tak AZA. Can serum C-reactive protein and procalcitonin levels associate with carpal tunnel syndrome? Medical Science and Discovery 2019;6:18-23.
• 23. Chikenji T, Gingery A, Zhao C, Passe SM, Ozasa Y, Larson D, et al. Transforming growth factor-β (TGF-β) expression is increased in the subsynovial connective tissues of patients with idiopathic carpal tunnel syndrome. J Orthop Res 2014;32:116-22.
• 24. Tepe N, Gülcen B. The role of CRP/albumin ratio in the carpal tunnel syndrome. Balıkesir Med J 2020;4:19-23.
• 25. Zhong JH, Huang DH, Chen ZY. Prognostic role of systemic immune-inflammation index in solid tumors: a systematic review and meta-analysis. Oncotarget 2017;8:75381-8.
• 26. Li LH, Chen CT, Chang YC, Chen YJ, Lee IH, How CK. Prognostic role of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune inflammation index in acute ischemic stroke: A STROBE-compliant retrospective study. Medicine (Baltimore) 2021;100:e26354.
• 27. Takasu S, Takatsu S, Kunitomo Y. Serum hyaluronic acid and interleukin-6 as possible markers of carpal tunnel syndrome in chronic hemodialysis patients. Artif Organs 1994; 18:420-4.
• 28. Güneş M, Büyükgöl H. Correlation of neutrophil/lymphocyte and platelet/lymphocyte ratios with the severity of idiopathic carpal tunnel syndrome. Muscle Nerve 2020;61:369-74.
• 29. Umay E, Karaahmet Z, Avluk Ö, Ünlü E, Çakçı A. [Relationship between the severity of compression and clinical symptoms, physical, functional and quality of life findings in patients with carpal tunnel syndrome] Turk J Phys Med Rehab 2011;57:93-200. [Article in Turkish]
• 30. De Kleermaeker FGCM, Boogaarts HD, Meulstee J, Verhagen VIM. Minimal clinically important difference for the Boston Carpal Tunnel Questionnaire: new insights and review of literature. J Hand Surg Eur Vol 2019;44:283-9.