University of Illinois, Chicago, USA.
Hand (N Y). 2023 Jan;18(1_suppl):43S-47S. doi: 10.1177/15589447211014607. Epub 2021 May 25.
Diabetes mellitus (DM) increases the risk for carpal tunnel syndrome (CTS) and is associated with its own neuropathic complications. Diabetic peripheral neuropathy (DPN) is a common complication seen in diabetic patients. In this study, we examine the relationship between the severity of DPN and CTS.
Type 2 diabetic and control patients (n = 292) were recruited at a clinic visit. The Michigan Neuropathy Screening Instrument (MNSI) questionnaire was used to collect data related to peripheral neuropathy. The MNSI scores were compared for patients with CTS with and without DM in univariable and multivariable analyses. χ analyses were performed to quantitatively measure the associations between peripheral neuropathy and the presence of CTS.
Of the 292 patients, 41 had CTS, and 19 of these had both CTS and DM. Of the 138 diabetic patients, 85 had peripheral neuropathy. There was no association between a diagnosis of CTS and an MNSI score indicative of peripheral neuropathy. In the diabetic population, CTS was inversely associated with DPN ( = .017). The MNSI scores between diabetic and control patients with CTS were comparable.
The severity of peripheral neuropathy in diabetic patients with and without CTS is comparable. Diabetic patients without peripheral neuropathy have an association with higher incidence of CTS in this study, suggesting that there are disparate mechanisms causing DPN and CTS. Nevertheless, diabetes and CTS are risk factors for developing the other, and future studies should further explore how DPN and CTS differ to tailor patient interventions based on their comorbidities.
糖尿病(DM)会增加腕管综合征(CTS)的风险,并与其自身的神经病变并发症相关。糖尿病周围神经病变(DPN)是糖尿病患者常见的并发症。在这项研究中,我们研究了 DPN 严重程度与 CTS 之间的关系。
在诊所就诊时招募了 292 例 2 型糖尿病和对照患者。使用密歇根州周围神经病变筛查工具(MNSI)问卷收集与周围神经病变相关的数据。在单变量和多变量分析中,比较了 CTS 患者和无 DM 的 CTS 患者的 MNSI 评分。进行卡方检验以定量测量周围神经病与 CTS 存在之间的关联。
在 292 名患者中,有 41 名患有 CTS,其中 19 名既有 CTS 又有 DM。在 138 名糖尿病患者中,有 85 名患有周围神经病。CTS 的诊断与提示周围神经病的 MNSI 评分之间没有关联。在糖尿病患者中,CTS 与 DPN 呈负相关( =.017)。患有 CTS 的糖尿病患者和对照组患者之间的 MNSI 评分相当。
在患有和不患有 CTS 的糖尿病患者中,周围神经病的严重程度相当。在这项研究中,没有周围神经病的糖尿病患者 CTS 的发生率更高,这表明导致 DPN 和 CTS 的机制不同。尽管如此,糖尿病和 CTS 是发展为另一种疾病的危险因素,未来的研究应进一步探索 DPN 和 CTS 的不同之处,以便根据患者的合并症为其制定干预措施。