2033 Obesity and Carpal Tunnel Syndrome: Unveiling a Population-Level Association Beyond Diabetic Neuropathy

INTRODUCTION: Although the relationship between diabetes mellitus (DM) and carpal tunnel syndrome (CTS) is well-documented due to diabetic neuropathic complications, a relationship specific to CTS and obesity has not yet been identified on a population level. METHODS: Data used in this study came from Epic Cosmos, a community collaboration of health systems representing over 227,000,000 patient records from over 1,301 hospitals and 28,600 clinics. All patients at least 18 years of age with an encounter between 12/7/2013 and 12/6/2023 were included and assorted based on presence or absence of ICD-10 codes for CTS, obesity, and DM. 99% confidence intervals were recorded, and odds ratios (OR) were calculated using p<0.01 for group comparison. RESULTS: All adult patients with a documented obesity diagnosis (n=26,702,609) showed a significant, near 6-fold increase in CTS prevalence (5.9% ± 0.012%) compared with non-obese adult patients (n=161,410,353; 1.1% ± 0.002%; OR=5.41, p<0.0001). When excluding those with a documented DM diagnosis, this relationship was largely maintained with a significant, 5-fold increased prevalence in obese adults without DM (n=18,720,709; 5.0% ± 0.013%) compared with non-obese adults without DM (n=150,929,553; 1.0% ± 0.002%; OR=5.21, p<0.0001). Additionally, obese adults without DM had a higher rate of CTS compared to non-obese, diabetic adults (n=10,480,800; 3.1 ± 0.014%; OR=1.65, p<0.0001). CONCLUSIONS: While DM patients are classically associated with CTS presentation, obesity, even without DM, may possess a similar or more powerful relationship. Additionally, comorbidity of obesity and DM suggests an additive effect between the two diagnoses on increased CTS prevalence. However, further research must be undergone to evaluate the anatomic and pathologic mechanism of this relationship.