Kim Yoo Hwan, Yang Kyung Sook, Kim Hanjun, Seok Hung Youl, Lee Jung Hun, Son Myeong Hun, Kim Byung Jo
Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
Department of Neurology, Hangang Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea.
J Clin Neurol. 2017 Jul;13(3):243-249. doi: 10.3988/jcn.2017.13.3.243.
Diabetes mellitus (DM) has been proposed as a risk factor for carpal tunnel syndrome (CTS), but this remains controversial. We investigated the association between DM and CTS using both ultrasonography (US) and nerve conduction study (NCS) data.
We analyzed a prospectively recruited database of neuromuscular US and medical records of subjects who had undergone NCSs and electromyography for symptoms suggestive of CTS. Subjects were assigned to the follow groups: Group I, CTS with DM; Group II, CTS without DM; Group III, no CTS with DM; and Group IV, no CTS without DM. US cross-sectional area (CSA) and NCS measurements at the median nerve (MN) were compared among groups. We used a general linear mixed model to adjust for statistically significant covariates.
The 230 participants comprised 22, 83, 19, and 106 in Groups I-IV, respectively. In multivariate analyses, the MN action potential amplitude in females was the only variable that was significantly associated with DM (p<0.001). Groups with DM tended to have a longer latency, smaller amplitude, and lower conduction velocity in the NCSs compared to groups without DM. The measured US CSA values did not differ significantly among the groups.
NCS measurements of the MN tended to differ between DM and non-DM patients regardless of the presence or absence of CTS. However, US did not reveal any statistically significant relationship between CTS and DM.
糖尿病(DM)已被提出是腕管综合征(CTS)的一个危险因素,但这仍存在争议。我们使用超声检查(US)和神经传导研究(NCS)数据来调查DM与CTS之间的关联。
我们分析了一个前瞻性招募的神经肌肉超声数据库以及因疑似CTS症状而接受NCS和肌电图检查的受试者的病历。受试者被分为以下几组:第一组,患有DM的CTS患者;第二组,不患有DM的CTS患者;第三组,患有DM但无CTS的患者;第四组,既无DM也无CTS的患者。比较了各组正中神经(MN)的超声横截面积(CSA)和NCS测量值。我们使用一般线性混合模型来调整具有统计学意义的协变量。
230名参与者中,第一至四组分别有22、83、19和106人。在多变量分析中,女性的MN动作电位幅度是唯一与DM显著相关的变量(p<0.001)。与无DM的组相比,有DM的组在NCS中往往具有更长的潜伏期、更小的幅度和更低的传导速度。各组测量的US CSA值之间没有显著差异。
无论是否存在CTS,DM患者与非DM患者的MN的NCS测量结果往往存在差异。然而,US未显示CTS与DM之间存在任何统计学上的显著关系。