Comorbidities, anthropometric, demographic, and lifestyle risk factors for ulnar neuropathy at the elbow: A case control study
Corresponding Author
Mauro Mondelli
EMG Service, Local Health Unit Toscana Sud Est, Siena, Italy
Correspondence
Dr Mauro Mondelli, MD, EMG Service, Local Health Unit Toscana Sud Est, Via Pian d'Ovile, 9, Siena 53100, Italy.
Email: [email protected]
Search for more papers by this authorStefano Mattioli
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorClaudia Vinciguerra
EMG Service, Local Health Unit Toscana Sud Est, Siena, Italy
Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
Search for more papers by this authorPalma Ciaramitaro
Clinical Neurophysiology, CTO, Department of Neuroscience, AOU “Città della Salute e della Scienza”, Torino, Italy
Search for more papers by this authorAlessandro Aretini
EMG Service, Local Health Unit Toscana Sud Est, Siena, Italy
Search for more papers by this authorGiuseppe Greco
EMG Service, Local Health Unit Toscana Sud Est, “Nottola” Hospital, Montepulciano, Siena, Italy
Search for more papers by this authorFrancesco Sicurelli
Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
Search for more papers by this authorStefano Giorgi
Clinical Neurophysiology, CTO, Department of Neuroscience, AOU “Città della Salute e della Scienza”, Torino, Italy
Search for more papers by this authorStefania Curti
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorCorresponding Author
Mauro Mondelli
EMG Service, Local Health Unit Toscana Sud Est, Siena, Italy
Correspondence
Dr Mauro Mondelli, MD, EMG Service, Local Health Unit Toscana Sud Est, Via Pian d'Ovile, 9, Siena 53100, Italy.
Email: [email protected]
Search for more papers by this authorStefano Mattioli
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorClaudia Vinciguerra
EMG Service, Local Health Unit Toscana Sud Est, Siena, Italy
Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
Search for more papers by this authorPalma Ciaramitaro
Clinical Neurophysiology, CTO, Department of Neuroscience, AOU “Città della Salute e della Scienza”, Torino, Italy
Search for more papers by this authorAlessandro Aretini
EMG Service, Local Health Unit Toscana Sud Est, Siena, Italy
Search for more papers by this authorGiuseppe Greco
EMG Service, Local Health Unit Toscana Sud Est, “Nottola” Hospital, Montepulciano, Siena, Italy
Search for more papers by this authorFrancesco Sicurelli
Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
Search for more papers by this authorStefano Giorgi
Clinical Neurophysiology, CTO, Department of Neuroscience, AOU “Città della Salute e della Scienza”, Torino, Italy
Search for more papers by this authorStefania Curti
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorAbstract
We performed a prospective multicenter case-control study to explore the association between ulnar neuropathy at elbow (UNE) and body and elbow anthropometric measures, demographic and lifestyle factors, and comorbidities. Cases and controls were consecutively enrolled among subjects admitted to four electromyography labs. UNE diagnosis was made on clinical and neurographic findings. The control group included all other subjects without signs/symptoms of ulnar neuropathy and with normal ulnar nerve neurography. Anthropometric measurements included weight, height, waist, hip circumferences, and external measures of elbow using a caliper. The participants filled in a self-administered questionnaire on personal characteristics, lifestyle factors, and medical history. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) by fitting unconditional logistic regression models adjusted by center and education level. We enrolled 220 cases (males 61.8%; mean age 51.7 years) and 460 controls (47.4% males; mean age 47.8 years). At multivariable analysis, UNE was associated to male gender (OR = 2.4, 95%CI = 1.6-3.7), smoking habits (>25 pack-years (OR = 2.3, 95%CI = 1.3-4.1), body mass index (OR = 1.05, 95%CI 1.01-1.10), polyneuropathies (OR = 4.1, 95%CI 1.5-11.5), and leaning with flexed elbow on a table/desk (OR = 1.5, 95%CI 1.0-2.2). Cubital groove width (CGW) turned out to be negatively associated with UNE (OR = 0.80, 95%CI = 0.74-0.85). Our study suggests that some personal factors especially anthropometric measures of the elbow may play a role in UNE pathogenesis as the measures of wrist in CTS. We demonstrated that for each millimeter of smaller CGW the risk of idiopathic UNE increases of 25%.
CONFLICT OF INTEREST
The authors declare no potential conflict of interest.
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