Relationships between serum mercaptoalbumin/non-mercaptoalbumin ratio, 25(OH)D level, symptom severity, functional status and median nerve cross-sectional area in carpal tunnel syndrome

腕管综合征中血清巯基白蛋白/非巯基白蛋白比值、25(OH)D 水平、症状严重程度、功能状态和正中神经横截面积之间的关系

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Abstract

OBJECTIVES: This study aims to investigate mercaptoalbumin and non-mercaptoalbumin (HNA%) levels in the serum of patients with idiopathic carpal tunnel syndrome (CTS) and to explore the correlation between serum HNA% and symptom severity, functional status, electrophysiological findings (EPFs), median nerve cross-sectional area (MNCSA) measured by ultrasound, and vitamin D levels. PATIENTS AND METHODS: Between April 2022 and November 2023, this prospective, case-controlled study included a total of 47 patients diagnosed with bilateral CTS (6 males, 41 females; mean age: 45.4±9.0 years; range, 25 to 60 years) and 34 healthy controls (4 males, 30 females; mean age: 42.5±10.8 years; range, 27 to 60 years) were included. Evaluation parameters included pain as measured by Visual Analog Scale (VAS), pinch grip strength (kg), Boston Carpal Tunnel Questionnaire (BCTQ), EPF, MNCSA by ultrasonography (mm(2) ), mercaptoalbumin and non-mercaptoalbumin ratio in serum (HNA%=HNA /Total albumin ×100) and 25(OH)D. RESULTS: The MNCSA was significantly higher in patients with CTS than healthy controls (p<0.001). The HNA% was significantly higher and 25(OH)D levels were significantly lower in patients with CTS than in healthy controls (p<0.001 and p=0.003, respectively). The HNA% was positively correlated symptom severity score (SSS) and functional status score (FSS) (r=0.396, p=0.006; r=0.29, p=0.042, respectively), and negatively correlated with 25(OH)D (r=-0.320, p=0.028). There was no relationship between HNA% and EPF and MNCSA. CONCLUSION: Our study results suggest that HNA% may be a new biomarker of oxidative stress in CTS. There is a relationship between HNA% and symptom severity, functional status, and low vitamin D levels.

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