Hiredesai Annika N, Howlett Carina P, Kisiel Sara, Unadkat Krishna, Verhey Jens T, Renfree Kevin J, Noland Shelley S
Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA.
University of Arizona College of Medicine, Phoenix, USA.
Hand (N Y). 2025 Jul 16:15589447251350181. doi: 10.1177/15589447251350181.
Diabetic patients experience carpal tunnel syndrome (CTS) at high rates, have increased symptom severity, and experience prolonged recovery after carpal tunnel release (CTR). This study assessed the association of glucagon-like peptide-1 receptor agonist (GLP-1) therapy with postoperative outcomes after CTR in type II diabetic patients with CTS.
Using the PearlDiver database, 25 229 diabetic patients with CTS who underwent CTR and were prescribed GLP-1 therapy were identified and exact matched to 25 229 controls based on age, sex, Elixhauser comorbidity index, tobacco use, obesity, hypothyroidism, and body mass index where available. Demographic variables and comorbidities were compared between groups using Kruskal-Wallis analyses for continuous variables and chi-square tests for categorical variables. Bivariate logistic regression analysis was conducted for 90-day outcomes and 2-year CTR revision.
Patients on GLP-1 therapy had decreased risk of 90-day medical complications (odds ratio [OR] = 0.90; 95% confidence interval [CI], 0.84-0.96) and hospital readmission (OR = 0.85; 95% CI, 0.77-0.94) of 0.5% and 0.4%, respectively, compared with controls. No significant differences were found in 90-day surgical complications or 2-year revision rates between cohorts. There were no cases of aspiration pneumonia. The GLP-1 cohort had increased odds of higher 90-day total costs of care (OR = 2.42; 95% CI, 1.88-3.15).
GLP-1 therapy is associated with reduced risk of 90-day medical complications and hospital readmission following CTR in diabetic patients, suggesting these medications may optimize comorbidity profiles via glucose control preoperatively. Future studies may examine whether GLP-1 therapy is associated with minimum clinically important difference in patient-reported outcome measures for CTS in diabetic patients.
糖尿病患者患腕管综合征（CTS）的几率很高，症状严重程度增加，且在腕管松解术（CTR）后恢复时间延长。本研究评估了胰高血糖素样肽-1受体激动剂（GLP-1）治疗与II型糖尿病合并CTS患者CTR术后结局之间的关联。
利用PearlDiver数据库，确定了25229例接受CTR并接受GLP-1治疗的糖尿病CTS患者，并根据年龄、性别、埃利克斯豪泽合并症指数、吸烟情况、肥胖、甲状腺功能减退和体重指数（如适用）与25229例对照进行精确匹配。使用Kruskal-Wallis分析对连续变量进行组间人口统计学变量和合并症比较，使用卡方检验对分类变量进行比较。对90天结局和2年CTR翻修进行二元逻辑回归分析。
与对照组相比，接受GLP-1治疗的患者90天医疗并发症风险（优势比[OR]=0.90；95%置信区间[CI]，0.84-0.96）和再次入院风险（OR=0.85；95%CI，0.77-0.94）分别降低了0.5%和0.4%。队列之间在90天手术并发症或2年翻修率方面未发现显著差异。无吸入性肺炎病例。GLP-1队列90天总护理费用较高的几率增加（OR=2.42；95%CI，1.88-3.15）。
GLP-1治疗与糖尿病患者CTR术后90天医疗并发症和再次入院风险降低相关，表明这些药物可能通过术前血糖控制优化合并症情况。未来的研究可以探讨GLP-1治疗是否与糖尿病患者CTS的患者报告结局测量中的最小临床重要差异相关。
