Predictive Value of Markers of Adiposity in Carpal Tunnel Syndrome: A Clinical and Electrophysiological Evaluation

Objective: To determine the association of total and segmental body composition adiposity indices with electrophysiological indicators of CTS. Study Design: Observational cross-sectional study. Place and Duration of Study: Departments of Medicine and Clinical Physiology at King Saud University Medical City, King Saud University, Riyadh from August 2018 to December 2019. Methodology: Total and segmental body composition analyses were performed by a bio-impedance body composition analyser. All the patients were grouped according to body mass index [BMI], total body fat % [TBF%], total fat mass [TFM], arm fat % [AF%], arm fat mass [AFM], and visceral fat rating [VFR] scores. Nerve conduction studies ( NCS) were performed according to the standard protocols. Results: CTS clinical severity score and CTS by NCS correlated significantly with BMI, TBF%, TFM, VFR, AF% and AFM. In ROC analysis, it was revealed that adiposity indices including BMI, TFM, VFR and AFM were significant predictors of abnormal NCS with area under the curve (AUC) of 0.824, 0.795, 0.795, and 0.803, respectively. VFR was a significant independent predictor of CTS severity (beta coefficient=0.613, p<0.001) and delayed median nerve latency (beta coefficient=0.317, p=0.017). Conclusion: Total and segmental body composition adiposity indicators are significantly associated with clinical severity of CTS and electrophysiological markers; especially, visceral adiposity. Large scale studies are required to explore the true predictive value of body composition in CTS.