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肢端肥大症患者疾病活动度和身体成分参数对正中神经横截面积的影响。

Influence of Disease Activity and Body Composition Parameters on Cross-Sectional Area of the Median Nerve in Acromegalic Patients.

机构信息

Department of Endocrinology, National Institute of Endocrinology and Diabetology, Ľubochňa, Slovakia.

出版信息

Physiol Res. 2021 Dec 30;70(6):921-929. doi: 10.33549/physiolres.934681. Epub 2021 Oct 30.

Abstract

Carpal tunnel syndrome (CTS) is neuropathy that occurs due to compression of the median nerve in the carpal tunnel. Acromegaly is one of the important causes of CTS. The aim of this study was to examine median nerve with ultrasound in acromegalic patients and to assess the relationship with activity, duration of disease and body composition parameters. We prospectively examined the cross-sectional area (CSA) of the median nerve with high-resolution ultrasound in 107 acromegalic patients (70 females and 37 males) and 107 healthy controls (70 females and 37 males) matched for age, gender, and BMI. Body composition parameters were assessed by dual-energy X-ray absorptiometry (DXA). The Student t-tests and Pearson correlation were used for data analysis. The cross sectional area of the median nerve was increased in acromegalic patients compared to controls (11.9 ± 4.8 mm2 vs. 7.7 ± 2.4 mm2, P < 0.001). Positive correlation was found between IGF-1 levels and CSA in the acromegalic group (R = 0.400, P < 0.001). Relationship between CSA and duration of acromegaly was not confirmed. In acromegalic patients, BMI correlated with the CSA (R = 0.294, P = 0.002). There was no significant difference in BMI, fat mass between the acromegalic and control group, but lean mass was higher in acromegalic patients compared with controls (54.8 ± 13.3 vs. 51 ± 11.6, P = 0.047). Lean mass and LMI (total body lean mass/height) positively correlated with CSA in acromegalic patients (R = 0.340, P < 0.001; R = 0.424, P < 0.001). No correlation was observed between fat mass and CSA of median nerve in all groups. We confirmed the enlargement of the median nerve in acromegalic patients. This enlargement is proportional to the degree of IGF-1 levels and is not dependent on the duration of the disease. The enlargement of the median nerve in acromegalic patients also depends on lean body mass and is not dependent on fat body mass.

摘要

腕管综合征(CTS)是一种由于正中神经在腕管中受压而引起的神经病。肢端肥大症是 CTS 的重要原因之一。本研究旨在通过超声检查肢端肥大症患者的正中神经,并评估其与活动、疾病持续时间和身体成分参数的关系。我们前瞻性地检查了 107 例肢端肥大症患者(70 名女性和 37 名男性)和 107 名健康对照组(70 名女性和 37 名男性)的正中神经横截面积(CSA),这些患者在年龄、性别和 BMI 方面均匹配。通过双能 X 线吸收法(DXA)评估身体成分参数。使用学生 t 检验和 Pearson 相关分析进行数据分析。肢端肥大症患者的正中神经 CSA 大于对照组(11.9 ± 4.8mm2 比 7.7 ± 2.4mm2,P < 0.001)。在肢端肥大症组中,IGF-1 水平与 CSA 呈正相关(R = 0.400,P < 0.001)。但 CSA 与肢端肥大症持续时间之间的关系未得到证实。在肢端肥大症患者中,BMI 与 CSA 相关(R = 0.294,P = 0.002)。肢端肥大症组和对照组之间的 BMI、脂肪量无显著差异,但与对照组相比,肢端肥大症患者的瘦体量较高(54.8 ± 13.3 比 51 ± 11.6,P = 0.047)。在肢端肥大症患者中,瘦体量和 LMI(全身瘦体量/身高)与 CSA 呈正相关(R = 0.340,P < 0.001;R = 0.424,P < 0.001)。在所有组中,脂肪量与正中神经 CSA 之间均无相关性。我们证实了肢端肥大症患者正中神经的增大。这种增大与 IGF-1 水平的程度成正比,且不依赖于疾病的持续时间。肢端肥大症患者正中神经的增大还取决于瘦体重,而与脂肪体重无关。

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