Mondelli Mauro, Curti Stefania, Mattioli Stefano, Aretini Alessandro, Ginanneschi Federica, Greco Giuseppe, Farioli Andrea
EMG Service, Local Health Unit No. 7, Siena, Italy.
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Arch Phys Med Rehabil. 2016 Sep;97(9):1456-1464. doi: 10.1016/j.apmr.2016.03.028. Epub 2016 Apr 26.
To assess the associations between carpal tunnel syndrome (CTS) severity and selected anthropometric and obesity indexes.
We performed a case-control study. Clinical and electrophysiological severity of CTS was classified as mild, moderate, or severe based on validated scales. Body and hand anthropometric characteristics were measured at the time of the electrodiagnostic study. We estimated the relative risk ratios (RRRs) of CTS severity by fitting multinomial logistic regression models adjusted by age and sex. In addition, we fitted multivariable models, including age, sex, wrist ratio, hand ratio, body mass index (BMI), and waist/stature ratio.
Electromyography laboratories.
Consecutive patients (N=1087), those with CTS (n=340) and those without CTS (n=747), were enrolled.
Not applicable.
Associations between CTS severity and selected anthropometric and obesity indexes.
We observed associations between many anthropometric indexes and CTS severity. Among obesity indexes, the waist/stature ratio, and among hand anthropometric indexes, the wrist/palm ratio, showed the highest RRRs for the clinical and electrophysiological severity scales. The RRRs of severe CTS (adjusted for age and sex) for the wrist/palm ratio were 3.5 for the clinical scale and 2.4 for the electrophysiological scale. The RRRs of severe CTS for the waist/stature ratio were 2.3 for the clinical scale and 2.0 for the electrophysiological scale. In the multivariable models, both BMI and the waist/stature ratio were associated with the outcomes.
Different configurations of the body and, in particular, the hand and wrist system may influence the occurrence and severity of CTS. Multiple obesity indexes, possibly including the waist/stature ratio, should be considered when investigating the association between body composition and CTS. Future studies should determine whether in obese subjects with CTS the weight and waist circumference loss produces an improvement in CTS symptoms and recovery of distal conduction velocity of the median nerve.
评估腕管综合征（CTS）严重程度与选定的人体测量指标和肥胖指数之间的关联。
我们进行了一项病例对照研究。根据经过验证的量表，将CTS的临床和电生理严重程度分为轻度、中度或重度。在进行电诊断研究时测量身体和手部的人体测量特征。我们通过拟合经年龄和性别调整的多项逻辑回归模型来估计CTS严重程度的相对风险比（RRR）。此外，我们还拟合了多变量模型，包括年龄、性别、腕部比例、手部比例、体重指数（BMI）和腰围/身高比。
肌电图实验室。
纳入了连续的患者（N = 1087），其中患有CTS的患者（n = 340）和未患有CTS的患者（n = 747）。
不适用。
CTS严重程度与选定的人体测量指标和肥胖指数之间的关联。
我们观察到许多人体测量指标与CTS严重程度之间存在关联。在肥胖指数中，腰围/身高比，以及在手的人体测量指标中，腕部/手掌比，在临床和电生理严重程度量表中显示出最高的RRR。腕部/手掌比的重度CTS（经年龄和性别调整）的RRR在临床量表中为3.5，在电生理量表中为2.4。腰围/身高比的重度CTS的RRR在临床量表中为2.3，在电生理量表中为2.0。在多变量模型中，BMI和腰围/身高比均与结果相关。
身体的不同形态，尤其是手部和腕部系统，可能会影响CTS的发生和严重程度。在研究身体成分与CTS之间的关联时，应考虑多种肥胖指数，可能包括腰围/身高比。未来的研究应确定，对于患有CTS的肥胖受试者，体重和腰围的减轻是否会改善CTS症状以及正中神经远端传导速度的恢复情况。
