Associations Between Body Anthropometric Measures and Severity of Carpal Tunnel Syndrome

Publication date: Available online 26 April 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Mauro Mondelli, Stefania Curti, Stefano Mattioli, Alessandro Aretini, Federica Ginanneschi, Giuseppe Greco, Andrea Farioli
ObjectiveTo assess the associations between carpal tunnel syndrome (CTS) severity and selected anthropometric and obesity indexes.DesignWe performed a case-control study. Clinical and electrophysiological severity of CTS was classified as mild, moderate or severe based on validated scales. Body and hand anthropometric characteristics were measured at the time of the electrodiagnostic study. We estimated the relative risk ratios (RRR) of CTS severity by fitting multinomial logistic regression models adjusted by age and sex. In addition we fitted multivariable models including age, sex, wrist ratio, hand ratio, body mass index (BMI), and waist-stature ratio.SettingConsecutive patients referred to three electromyography laboratories.ParticipantsWe enrolled 370 cases and 747 controls.InterventionsN/AMain Outcome MeasuresAssociations between CTS severity and selected anthropometric and obesity indexes.ResultsWe observed associations between many anthropometric indexes and CTS severity. Among obesity indexes the waist-stature ratio and among hand anthropometric indexes the wrist-palm ratio showed the highest RRR for clinical and electrophysiological severity scale. RRR of severe CTS (adjusted for age and sex) for the wrist-palm ratio were 3.5 for clinical scale and 2.4 for electrophysiological scale. RRR of severe CTS for waist-stature ratio were 2.3 for clinical scale and 2.0 for electrophysiological scale. In the multivariable models, both BMI and waist-stature ratio were associated with the outcomes.ConclusionsDifferent configurations of the body and, in particular, the hand and wrist system may influence the occurrence and severity of CTS. Multiple obesity indexes, possibly including waist-stature ratio, should be considered when investigating the association between body composition and CTS. Future studies should determine whether in obese subjects with CTS the weight and waist circumference loss may produce an improvement in CTS symptoms and recovery of distal conduction velocity of the median nerve.



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