Mauro Mondelli1, Alessandro Aretini2, Federica Ginanneschi3, Giuseppe Greco4, Stefano Mattioli5. 1. EMG Service, Local Health Unit 7, Siena, Italy. Electronic address: m.mondelli@usl7.toscana.it. 2. EMG Service, Local Health Unit 7, Siena, Italy. 3. Dpt. Neurological, Neurosurgical and Behavioural Sciences, University of Siena, Italy. 4. EMG Service, Local Health Unit 7, "Nottola" Hospital, Montepulciano, Siena, Italy. 5. Dpt. Medical and Surgical Sciences, University of Bologna, Italy.
Abstract
BACKGROUND: The association between carpal tunnel syndrome (CTS) and high body mass index (BMI) and some hand measures is well known. No study has been specifically focused on waist circumference (WC) and waist-to-hip-ratio (WHR). The aim of this prospective case-control study is to evaluate the association between CTS and WC, WHR and other body and hand anthropometric measures. METHODS: We consecutively enrolled one "idiopathic" CTS case for two controls in 3 outpatient electromyography labs. The main anthropometric measures were BMI, WC, WHR, wrist ratio (WR) and hand ratio (HR). We performed univariate and multivariate analyses. RESULTS: Female cases and controls were 250 and 474 and male cases and controls were 120 and 273, respectively. At univariate analysis there were differences in many anthropometric measures between cases and controls. At multivariate logistic regression analyses high BMI, WC and WHR and abnormal HR and WR were independent risk factors for CTS. Crossing two categories between BMI, WC and WHR, the overweight subjects, especially females, were at risk only if they had very high WC or high WHR. The risk increased if they were obese. CONCLUSIONS: High WC/WHR doubles the risk of CTS, the risk further increased if overweight/obese subjects have also very high WC or high WHR. The obese subjects were always at risk regardless of WC and WHR values. Metabolic causes of this association with CTS were hypothesised. BMI is not the only and most powerful body predictor of "idiopathic" CTS, but also WHR and WC should be considered. These measures may not be interchangeable and it may be desirable to consider the utility of their joint use.
BACKGROUND: The association between carpal tunnel syndrome (CTS) and high body mass index (BMI) and some hand measures is well known. No study has been specifically focused on waist circumference (WC) and waist-to-hip-ratio (WHR). The aim of this prospective case-control study is to evaluate the association between CTS and WC, WHR and other body and hand anthropometric measures. METHODS: We consecutively enrolled one "idiopathic" CTS case for two controls in 3 outpatient electromyography labs. The main anthropometric measures were BMI, WC, WHR, wrist ratio (WR) and hand ratio (HR). We performed univariate and multivariate analyses. RESULTS: Female cases and controls were 250 and 474 and male cases and controls were 120 and 273, respectively. At univariate analysis there were differences in many anthropometric measures between cases and controls. At multivariate logistic regression analyses high BMI, WC and WHR and abnormal HR and WR were independent risk factors for CTS. Crossing two categories between BMI, WC and WHR, the overweight subjects, especially females, were at risk only if they had very high WC or high WHR. The risk increased if they were obese. CONCLUSIONS: High WC/WHR doubles the risk of CTS, the risk further increased if overweight/obese subjects have also very high WC or high WHR. The obese subjects were always at risk regardless of WC and WHR values. Metabolic causes of this association with CTS were hypothesised. BMI is not the only and most powerful body predictor of "idiopathic" CTS, but also WHR and WC should be considered. These measures may not be interchangeable and it may be desirable to consider the utility of their joint use.
Keywords:
Body mass index; Carpal tunnel syndrome; Hand ratio; Nerve entrapment syndrome; Obesity; Waist circumference; Waist-to-hip ratio; Wrist ratio
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