ArticleJournal of orthopaedic surgery and research2026
Health-related factors and epigenetic alterations in metabolic comorbidities patients and smokers with carpal tunnel syndrome: a preliminary investigation of patient-derived samples.
Article in Journal of orthopaedic surgery and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCarpal tunnel syndrome (CTS) is a common painful musculoskeletal disorder caused by inflammation and hypertrophy of the flexor retinaculum. Significant relationships exist between CTS, metabolic syndrome, smoking, and health-related factors, but the molecular mechanisms remain poorly understood.
methodsThis cross-sectional preliminary investigation was conducted at Al-Razi Hospital (Department of Orthopaedics), Kuwait, between October 2022 and September 2023. Tissue samples from the flexor retinaculum were collected following carpal tunnel release surgery from patients with symptomatic CTS. Seven groups were included: healthy control (n = 10), trigger finger (control for gene expression analysis; n = 10), CTS (n = 10), diabetic CTS (n = 9), hypertensive CTS (n = 7), dyslipidemic CTS (n = 7), and smoker CTS (n = 9). Expression levels of CTS-related genes (COL-I, COL-II) and inflammatory genes (TNF-α) were evaluated by reverse transcription-polymerase chain reaction (RT-PCR). Participants completed the Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index (PSQI), Disability of the Arm, Shoulder and Hand (DASH), Numeric Pain Rating Scale (NRS), and Satisfaction with Life Scale (SWLS) questionnaires. One-way ANOVA with Bonferroni post-hoc correction and Pearson correlation analyses were used, with adjustment for confounders using directed acyclic graphs (DAGs).
resultsA total of 62 participants (33 males, 29 females; mean age 54 ± 6.9 years; mean BMI 28.2 ± 3.4 kg/m
conclusionsThis preliminary investigation demonstrates that hand dysfunction, stress levels, pain severity, and reduced life satisfaction in CTS patients are strongly associated with increased inflammation (tumor necrosis factor-alpha) and collagen gene expression (collagen type I and collagen type II) in patients with diabetes, hypertension, or dyslipidemia and smokers with CTS. These findings provide mechanistic insights into CTS pathophysiology. Further rigorous research with larger samples is needed to validate these preliminary findings.
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