腕部比值与腕管综合征之间的关联：体重指数的效应修正作用
Association between wrist ratio and carpal tunnel syndrome: Effect modification by body mass index.
作者信息
Thiese Matthew S, Merryweather Andrew, Koric Alzina, Ott Ulrike, Wood Eric M, Kapellusch Jay, Foster James, Garg Arun, Deckow-Schaefer Gwen, Tomich Suzanna, Kendall Richard, Drury David L, Wertsch Jacqueline, Hegmann Kurt T
机构信息
Rocky Mountain Center for Occupational and Environmental Health, University of Utah, 391 Chipeta Way, Suite C, Salt Lake City, Utah, 84108, USA.
Department of Mechanical Engineering, University of Utah, Salt Lake City, Utah, USA.
出版信息
Muscle Nerve. 2017 Dec;56(6):1047-1053. doi: 10.1002/mus.25692. Epub 2017 Jun 14.
INTRODUCTION
Previous studies have reported higher wrist ratios (WR) related to carpal tunnel syndrome (CTS) but have not assessed effect modification by obesity and may have inadequately controlled for confounders.
METHODS
Baseline data of a multicenter prospective cohort study were analyzed. CTS was defined by nerve conduction study (NCS) criteria and symptoms.
RESULTS
Among the 1,206 participants, a square-shaped wrist was associated with CTS after controlling for confounders (prevalence ratio = 2.27; 95% confidence interval [95% CI], 1.33-3.86). Body mass index (BMI) was a strong effect modifier on the relationship between WR and both CTS and abnormal NCS results, with normal weight strata of rectangular versus square wrists = 8.18 (95% CI, 1.63-49.96) and 7.12 (95% CI, 2.19-23.16), respectively.
DISCUSSION
A square wrist is significantly associated with CTS after controlling for confounders. Effect modification by high BMI masked the eightfold magnitude adjusted relationship seen between WR and CTS among normal weight participants. Muscle Nerve 56: 1047-1053, 2017.
引言
既往研究报告称腕部比值（WR）较高与腕管综合征（CTS）相关，但未评估肥胖对效应的修正作用，且可能未充分控制混杂因素。
方法
对一项多中心前瞻性队列研究的基线数据进行分析。CTS根据神经传导研究（NCS）标准和症状来定义。
结果
在1206名参与者中，校正混杂因素后，方形手腕与CTS相关（患病率比=2.27；95%置信区间[95%CI]，1.33 - 3.86）。体重指数（BMI）对WR与CTS及异常NCS结果之间的关系有很强的效应修正作用，在正常体重人群中，长方形手腕与方形手腕相比，CTS的患病率比分别为8.18（95%CI，1.63 - 49.96）和7.12（95%CI，2.19 - 23.16）。
讨论
校正混杂因素后，方形手腕与CTS显著相关。高BMI的效应修正作用掩盖了正常体重参与者中WR与CTS之间八倍的校正关系。《肌肉与神经》56: 1047 - 1053, 2017年。
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