Regeneron Pharmaceuticals, Inc., 777 Old Saw Mill River Road, Tarrytown, NY, USA.
BMC Musculoskelet Disord. 2024 Jun 15;25(1):468. doi: 10.1186/s12891-024-07459-1.
Carpal tunnel syndrome (CTS), an entrapment neuropathy caused by pressure of the median nerve, is a progressive condition that can lead to a decreased quality of life. Studies suggest an association between CTS and arthritis; however, previous studies examining osteoarthritis (OA) and CTS are limited in number, scope and study design. This study estimated the incidence and risk of CTS among patients with OA, both overall and by specific joints, in a large population-based cohort in the United States.
Patients from the Optum claims database aged ≥ 45 years and diagnosed with OA between January 1, 2018, and December 31, 2022, were eligible for the OA cohort. The non-OA cohort included those without a diagnosis of OA at the index date and no history of OA for 12 months pre-index. Baseline characteristics were balanced using propensity score matching. The risk of CTS in the OA and non-OA cohort were evaluated using incidence rates and adjusted hazard ratios that were estimated using Cox regression.
After applying the inclusion/exclusion criteria, 3,610,240 of the 6,023,384 adults with a diagnosis of OA remained in the OA cohort. After propensity-score matching, each cohort included 1,033,439 individuals. The incidence rates for CTS per 1000 person-years were 7.35 (95% confidence interval [CI] 7.21-7.49) in the OA cohort and 1.44 (95% CI 1.38-1.50) in the non-OA cohort. The risk of developing CTS in patients with OA was ~ 4 times that of patients without (hazard ratio = 3.80; 95% CI 3.54-4.07). This increased risk was found across all OA joint types, with OA of the hand/wrist having the highest risk for CTS. Additionally, multiple OA joints presented a higher risk compared with a single affected joint.
OA increases the risk of CTS, but this is not limited to patients with hand/wrist OA, suggesting a systemic impact of OA on CTS. While the risk appears highest for patients with hand/wrist OA, patients with more distant affected joints like knee or hip also have an increased risk of CTS.
腕管综合征（CTS）是一种由正中神经受压引起的嵌压性神经病，是一种进行性疾病，可导致生活质量下降。研究表明 CTS 与关节炎之间存在关联；然而，先前研究关节炎（OA）和 CTS 的研究数量有限，范围和研究设计有限。本研究估计了美国大型基于人群队列中 OA 患者的 CTS 发生率和风险，包括总体和特定关节。
来自 Optum 索赔数据库的年龄≥45 岁且在 2018 年 1 月 1 日至 2022 年 12 月 31 日期间被诊断为 OA 的患者有资格参加 OA 队列。非 OA 队列包括在索引日期没有 OA 诊断且在索引前 12 个月没有 OA 病史的患者。使用倾向评分匹配平衡基线特征。使用 Cox 回归估计发病率和调整后的风险比来评估 OA 和非 OA 队列中 CTS 的风险。
在应用纳入/排除标准后，6023384 名患有 OA 的成年人中有 3610240 名符合 OA 队列的条件。在进行倾向评分匹配后，每个队列各包括 1033439 名患者。每 1000 人年 CTS 的发病率分别为 OA 队列的 7.35（95%置信区间 [CI] 7.21-7.49）和非 OA 队列的 1.44（95%CI 1.38-1.50）。OA 患者发生 CTS 的风险是无 OA 患者的 4 倍左右（风险比=3.80；95%CI 3.54-4.07）。这种风险增加见于所有 OA 关节类型，手部/腕部 OA 发生 CTS 的风险最高。此外，与单个受累关节相比，多个 OA 关节呈现出更高的风险。
OA 增加了 CTS 的风险，但不限于手部/腕部 OA 患者，这表明 OA 对 CTS 的影响是全身性的。虽然手部/腕部 OA 患者的风险似乎最高，但膝部或髋部等更远端受累关节的患者也有更高的 CTS 风险。
