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2001 Prevalence of and Risk Factors For Carpal Tunnel Syndrome in A Rural Population
2001 Prevalence of and Risk Factors For Carpal Tunnel Syndrome in A Rural Population
2001 Prevalence of and Risk Factors For Carpal Tunnel Syndrome in A Rural Population
1 1
이종민ㆍ권용욱ㆍ최종철ㆍ최종호ㆍ임현술 ㆍ김수근
= Abstract =
Jongmin Lee, M.D., Yong Wook Kwon, M.D., Jong Chul Choi, M.D.,
Jong Ho Choi, M.D., Hyun-Sul Lim, M.D., Ph.D.1 and Soo-Keun Kim, M.D.1
Objective: The purpose of this study was to investigate the prevalence of and risk factors
for carpal tunnel syndrome in a rural population in Korea.
Method: Among the 1004 residents in a rural district who participated in the health exami-
nation, 450 (165 male, 285 female) adults aged between 30 and 79 years were randomly selected.
Hand symptom questionnaire and electrodiagnostic studies were used to diagnose and classify
carpal tunnel syndrome. General characteristics, female-related factors, work-related factors and
anthropometric measurements were compared between normal and carpal tunnel syndrome group
to identify the risk factors for carpal tunnel syndrome.
Results: Subjects with carpal tunnel syndrome were 76 (16.9%), symptom only subjects were
168 (37.3%), asymptomatic slowing 27 (6.0%) and peripheral polyneuropathy were 16 (3.6%).
Age, farming, body mass index and wrist depth width ratio were associated with risk of carpal
tunnel syndrome and odds ratio were 1.03 (95% confidence interval 1.01∼1.07), 2.62 (95%
confidence interval 1.17∼5.86), 2.24 (95% confidence interval 1.14∼4.40) and 3.13 (95%
confidence interval 1.64∼5.96), each.
Conclusion: These data suggest that the prevalence of carpal tunnel syndrome is high in a
rural population and physical factors like wrist shape and body mass index, occupation and aging
are associated with risk of carpal tunnel syndrome.
ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ
Key Words: Carpal tunnel syndrome, Prevalence, Risk factors
818
이종민 외 5인:일부 농촌 주민의 수근관 증후군 유병률과 위험요인 819
Table 5. Comparison of General Characteristics between Table 6. Comparison of Female-related Factors between
Normal and Carpal Tunnel Syndrome Group Normal and Carpal Tunnel Syndrome Group
ꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧ ꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧ
1) 1)
Variables Normal CTS p-value Variables Normal CTS p-value
ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ
Age (years) 0.073 Menarche (years) 17.0±1.6 17.0±1.7 0.983
30∼39 21 (87.5) 3 (12.5) Number of pregnancy 5.5±2.3 5.9±2.3 0.273
40∼49 24 (77.4) 7 (22.6) Number of delivery 4.0±1.8 4.3±1.7 0.427
50∼59 53 (60.9) 34 (39.1) Menopause (years) 47.2±5.3 46.7±6.8 0.687
60∼69 40 (63.5) 23 (36.5) Oral contraceptive use 0.151
70∼79 25 (73.5) 9 (26.5) Yes 33 (68.8) 15 (31.3)
Sex 0.001* No 53 (55.8) 42 (44.2)
Male 74 (81.3) 17 (18.7) Hysterectomy 0.703
Female 89 (60.1) 59 (39.9) Yes 5 (71.4) 2 (28.6)
Occupation 0.056 No 80 (59.7) 54 (40.3)
Farming 116 (64.8) 63 (35.2) Menopause time 0.102
Others 47 (78.3) 13 (21.7) <=1 year 7 (43.8) 9 (56.3)
Smoking 0.148 2∼5 years 7 (43.8) 9 (56.3)
Yes 64 (74.4) 22 (25.6) >5 years 75 (64.7) 41 (35.3)
No 99 (64.7) 54 (35.3)
Hand symptom at
Alcohol 0.001* 0.616
pregnancy
Yes 58 (82.9) 12 (17.1)
Yes 12 (66.7) 6 (33.3)
No 92 (59.7) 62 (40.3)
No 76 (59.4) 52 (40.6)
ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ
ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ
Values are numbers (%).
Values of menarche, number of pregnancy, number of
1. CTS: Carpal tunnel syndrome.
2 delivery and menopause are mean±standard deviation,
*p<0.05 by χ -test
and other values are numbers (%).
1. CTS: Carpal tunnel syndrome
Table 7. Comparison of Work-related Factors between Table 8. Comparison of Anthropometric Factors between
Normal and Carpal Tunnel Syndrome Group Normal and Carpal Tunnel Syndrome Group
ꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧ ꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧ
1) 1)
Variables Normal CTS p-value Variables Normal CTS p-value
ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ
2) 2
Dominant hand BMI (kg/m ) 0.021*
1) 0.909
and right CTS ≥25 38 (56.7) 29 (43.3)
Right 151 (74.0) 53 (26.0) <25 125 (72.7) 47 (27.3)
Left 8 (72.7) 3 (27.3) Wrist circumfer- 16.6±1.05 16.6±1.00 0.632
Bilateral 8 (80.0) 2 (20.0) ence (cm)
3) †
Dominant hand Wrist DWR 0.69±0.03 0.71±0.03 0.000
1) 0.481 †
and left CTS Hand length (cm) 17.9±0.95 17.5±0.97 0.013
†
Right 148 (72.5) 56 (27.5) Palm length (cm) 10.3±0.53 10.1±0.55 0.004
4)
Left 7 (58.3) 5 (41.7) LH ratio 1.12±0.04 1.12±0.04 0.874
Bilateral 8 (80.0) 2 (20.0) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ
Activity with wrist Values of BMI are numbers (%) and other values are
1.000 mean±standard deviation.
extension
Yes 62 (65.3) 33 (34.7) 1. CTS: Carpal tunnel syndromem, 2. BMI: Body mass
index, 3. Wrist DWR: Wrist depth/width ratio, 4. LH
No 54 (64.3) 30 (35.7)
ratio: Hand length/height ratio (mm/cm)
Activity with wrist
0.751 *p<0.05 by χ2-test, †p<0.05 by Student's t-test
flexion
Yes 68 (64.2) 38 (35.8)
No 48 (66.7) 24 (33.3)
Table 9. Odds Ratio of Risk Factors for Carpal Tunnel
Activity with pinch
0.083 Syndrome by Multiple Logistic Regression
grasp ꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧꠧ
1)
Yes 43 (57.3) 32 (42.7) Variables Odds ratio 95% CI
No 73 (70.2) 31 (29.8) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ
Activity with palm Age 1.03 1.01∼1.07
0.752 Sex 1.60 0.61∼4.13
pressing
Yes 48 (63.2) 28 (36.8) Farming 2.62 1.17∼5.86
No 68 (66.0) 35 (34.0) Alcohol 0.43 0.17∼1.14
Activity with repetitive Body mass index 2.24 1.14∼4.40
0.530 Wrist depth width ratio 3.13 1.64∼5.96
motion
Yes 49 (62.0) 30 (38.0) Hand length 1.31 0.69∼2.50
No 67 (67.0) 33 (33.0) Palm length 0.50 0.16∼1.50
ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ
Activity with vibration
0.334 1. CI: Confidence interval
tools
Yes 26 (72.2) 10 (27.8)
No 90 (62.9) 53 (37.1)
분석을 시행한 결과 연령, 농작업, 손목 깊이/폭 비
ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ
Values are numbers (%). 율 및 체질량지수가 통계적 유의성을 보였으며, 각
1. CTS: Carpal tunnel syndrome 변수의 교차비는 연령 1.03 (95% 신뢰구간: 1.01∼
1.07), 농작업 2.62 (95% 신뢰구간: 1.17∼5.86), 손목
은 통계적으로 유의한 차이를 보이지 않았다(Table 8). 깊이/폭 비율 3.13 (95% 신뢰구간: 1.64∼5.96), 체질
량지수 2.24 (95% 신뢰구간: 1.14∼4.40)이었다(Table 9).
3) 수근관 증후군의 위험요인에 대한 다변량
분석
고 찰
교란요인을 보정하기 위하여 단변량 분석에서 p값
이 0.1 이하를 보인 변수들로 다변량 로지스틱 회귀 수근관 증후군은 수근관내에서 정중신경이 압박되
이종민 외 5인:일부 농촌 주민의 수근관 증후군 유병률과 위험요인 823
위험 요인을 조사하여 다음과 같은 결과를 얻었다. P: Carpal tunnel syndrome: a nested case-control
1) 증상분류와 전기진단검사를 이용한 진단기준에 study of risk factors in women. Am J Epidemiol 2000;
151: 566-574
따라 수근관 증후군의 유병률은 16.9%이었으며, 증
9) Ferry S, Pritchard T, Keenan J, Croft P, Silman AJ:
상은 있으나 전기진단검사가 정상인 경우가 37.3%, 증
Estimating the prevalence of delayed median nerve
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6.0%이었다. 1998; 37: 630-635
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수가 통계적 유의성을 보였으며, 각변수의 교차비는
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