Journal of diabetes and its complications · 2026
Diabetes and the risk of entrapment neuropathies of the upper and lower extremity - A propensity score-matched cohort study.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Rydberg Mattias, Lakhlani Devi, Sutjiadi Brian Jonathan, Fox Paige M, Curtin Catherine
Аннотация
AIMS: To evaluate the association between diabetes and four peripheral nerve entrapment syndromes: carpal tunnel syndrome (CTS), ulnar nerve entrapment (UNE), radial nerve entrapment (RNE), and tarsal tunnel syndrome (TTS).
METHODS: This retrospective cohort study used the Merative™ MarketScan® Commercial Database (2007-2023). Adults ≥18 years were classified as having diabetes or serving as controls. Incident-only cohorts excluded individuals with prior diagnoses during a washout period. Propensity score matching (1:1, sex-stratified) reduced confounding, and Cox proportional hazards regression estimated time to incident diagnosis.
RESULTS: After matching, cohort sizes ranged from 6.5 to 6.8 million individuals. Diabetes was significantly associated with increased risk of all four entrapment neuropathies: CTS (HR 1.35; 95% CI 1.34-1.37), UNE (HR 1.23; 95% CI 1.21-1.24), TTS (HR 1.28; 95% CI 1.24-1.32), and RNE (HR 1.11; 95% CI 1.05-1.17; all P < 0.001). The strongest associations were observed in adults younger than 40 years with CTS (HR 1.68; 95% CI 1.63-1.73) and TTS (HR 1.56; 95% CI 1.42-1.72).
CONCLUSIONS: Diabetes is associated with increased risk across multiple anatomically distinct nerve entrapments, supporting generalized nerve vulnerability. Younger adults with diabetes may represent a high-risk subgroup warranting enhanced clinical surveillance.
METHODS: This retrospective cohort study used the Merative™ MarketScan® Commercial Database (2007-2023). Adults ≥18 years were classified as having diabetes or serving as controls. Incident-only cohorts excluded individuals with prior diagnoses during a washout period. Propensity score matching (1:1, sex-stratified) reduced confounding, and Cox proportional hazards regression estimated time to incident diagnosis.
RESULTS: After matching, cohort sizes ranged from 6.5 to 6.8 million individuals. Diabetes was significantly associated with increased risk of all four entrapment neuropathies: CTS (HR 1.35; 95% CI 1.34-1.37), UNE (HR 1.23; 95% CI 1.21-1.24), TTS (HR 1.28; 95% CI 1.24-1.32), and RNE (HR 1.11; 95% CI 1.05-1.17; all P < 0.001). The strongest associations were observed in adults younger than 40 years with CTS (HR 1.68; 95% CI 1.63-1.73) and TTS (HR 1.56; 95% CI 1.42-1.72).
CONCLUSIONS: Diabetes is associated with increased risk across multiple anatomically distinct nerve entrapments, supporting generalized nerve vulnerability. Younger adults with diabetes may represent a high-risk subgroup warranting enhanced clinical surveillance.