Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Eur J Endocrinol. 2021 Feb;184(2):209-216. doi: 10.1530/EJE-20-0530.
Carpal tunnel syndrome (CTS) is common in patients with acromegaly, with a reported prevalence of 19-64%. We studied CTS in a large national cohort of patients with acromegaly and the temporal relationship between the two diagnoses.
Retrospective, nationwide, cohort study including patients diagnosed with acromegaly in Sweden, 2005-2017, identified in the Swedish Healthcare Registries.
CTS (diagnosis and surgery in specialised healthcare) was analysed from 8.5 years before the diagnosis of acromegaly until death or end of the study. Standardised incidence ratios (SIRs) with 95% CIs were calculated for CTS with the Swedish population as reference.
The analysis included 556 patients with acromegaly (50% women) diagnosed at mean (s.d.) age 50.1 (15.0) years. During the study period, 48 patients were diagnosed with CTS and 41 patients underwent at least one CTS surgery. In the latter group, 35 (85%) were operated for CTS before the acromegaly diagnosis; mean interval (range) 2.2 (0.3-8.5) years and the SIR for having CTS surgery before the diagnosis of acromegaly was 6.6 (4.8-8.9). Women with acromegaly had a higher risk for CTS than men (hazard ratio: 2.5, 95% CI: 1.3-4.7).
Patients with acromegaly had a 6-fold higher incidence for CTS surgery before the diagnosis of acromegaly compared with the general population. The majority of patients with both diagnoses were diagnosed with CTS prior to acromegaly. Increased awareness of signs of acromegaly in patients with CTS might help to shorten the diagnostic delay in acromegaly, especially in women.
肢端肥大症患者中常见腕管综合征（CTS），发病率为 19%-64%。我们对瑞典一个肢端肥大症大型全国队列患者中的 CTS 进行了研究，并探讨了两种诊断之间的时间关系。
回顾性、全国性队列研究，纳入 2005 年至 2017 年期间在瑞典医疗保健注册中心诊断为肢端肥大症的患者。
从诊断为肢端肥大症前 8.5 年开始，直至死亡或研究结束，对 CTS（在专门的医疗保健机构中诊断和手术）进行分析。以瑞典人群为参照，计算 CTS 的标准化发病比（SIR）及其 95%置信区间（CI）。
该分析纳入了 556 例肢端肥大症患者（50%为女性），平均（标准差）年龄为 50.1（15.0）岁。在研究期间，48 例患者被诊断为 CTS，41 例患者至少接受过一次 CTS 手术。在后一组中，有 35 例（85%）在诊断为肢端肥大症之前接受了 CTS 手术；平均间隔（范围）为 2.2（0.3-8.5）年，诊断为肢端肥大症前接受 CTS 手术的 SIR 为 6.6（4.8-8.9）。与男性相比，女性肢端肥大症患者发生 CTS 的风险更高（风险比：2.5，95%CI：1.3-4.7）。
与普通人群相比，诊断为肢端肥大症前，肢端肥大症患者发生 CTS 手术的发病率高 6 倍。大多数同时患有这两种疾病的患者在肢端肥大症之前就被诊断出患有 CTS。在 CTS 患者中提高对肢端肥大症体征的认识，可能有助于缩短肢端肥大症的诊断延迟，尤其是在女性中。
