Cieľ: Cieľom štúdie bolo vyšetriť plochu priečneho rezu (cross-sectional area; CSA) nervus medianus pomocou UZ u akromegalických pacientov a posúdiť vzťah medzi CSA nervus medianus a aktivitou, trvaním akromegálie ako aj vekom pacientov. Materiál a metódy: Prospektívne sme vyšetrili CSA nervus medianus u 107 akromegalických pacientov (70 žien a 37 mužov) a u 77 zdravých kontrol (51 žien a 26 mužov) zodpovedajúcich veku, pohlaviu a indexu telesnej hmotnosti. Na analýzu údajov sme použili Studentov t-test a Pearsonovu koreláciu. Výsledky: CSA nervus medianus bola signifikantne väčšia u akromegalických pacientov v porovnaní so zdravými kontrolami (0,12 ± 0,005 cm2 vs. 0,078 ± 0,003 cm2; p < 0,001). Priemerná dĺžka trvania akromegálie bola 11 rokov, priemerná sérová hladina inzulínu podobného rastového faktora 1 (insulin-like growth factor 1; IGF-1) bola 249,9 ng/ml a rastového hormónu (RH) bola 2,63 ng/ml. Potvrdili sme pozitívnu koreláciu medzi sérovými hladinami IGF-1 a CSA nervus medianus u akromegalických pacientov (r = 0,400, p < 0,001). Nepotvrdili sme vzťah medzi CSA nervus medianus a sérov hladinou RH, dĺžkou ochorenia a vekom pacientov. Záver: V našej štúdii sme potvrdili zväčšenie nervus medianus u pacientov s akromegáliou. Toto zväčšenie je úmerné hladinám IGF-1 a nezávisí od dĺžky trvania ochorenia a veku pacientov.
Aim: The aim of this study was to examine the cross-sectional area (CSA) of the median nerve using ultrasound in acromegalic patients and to assess the relationship between the CSA of the median nerve and the activity, duration of acromegaly and age of patients. Materials and methods: We prospectively examined the CSA of the median nerve in 107 acromegalic patients (70 women and 37 men) and in 77 healthy controls (51 women and 26 men) matched for age, sex and body mass index. The Student t-test and Pearson correlation were used for data analysis. Results: The CSA of the median nerve was significantly greater in acromegalic patients compared with healthy controls (0.12 ± 0.005 cm2 vs. 0.078 ± 0.003 cm2; P < 0.001). The average duration of acromegaly was 11 years, average serum insulin-like growth factor 1 (IGF-1) level was 249.9 ng/mL and average growth hormone (RH) level was 2.63 ng/mL. We confirmed a positive correlation between the serum levels of IGF-1 and CSA of the median nerve in acromegalic patients (R = 0.400, P < 0.001). We did not confirm a relationship between CSA of the median nerve and serum levels of GH, duration of acromegaly and age of patients. Conclusion: In our study, we confirmed enlargement of the median nerve in patients with acromegaly. This enlargement depends on IGF-1 levels and is not depend on the duration of acromegaly and age of the patients.
Carpal tunnel syndrome (CTS) is neuropathy that occurs due to compression of the median nerve in the carpal tunnel. Acromegaly is one of the important causes of CTS. The aim of this study was to examine median nerve with ultrasound in acromegalic patients and to assess the relationship with activity, duration of disease and body composition parameters. We prospectively examined the cross-sectional area (CSA) of the median nerve with high-resolution ultrasound in 107 acromegalic patients (70 females and 37 males) and 107 healthy controls (70 females and 37 males) matched for age, gender, and BMI. Body composition parameters were assessed by dual-energy X-ray absorptiometry (DXA). The Student t-tests and Pearson correlation were used for data analysis. The cross sectional area of the median nerve was increased in acromegalic patients compared to controls (11.9 ± 4.8 mm2 vs. 7.7 ± 2.4 mm2, P < 0.001). Positive correlation was found between IGF-1 levels and CSA in the acromegalic group (R = 0.400, P < 0.001). Relationship between CSA and duration of acromegaly was not confirmed. In acromegalic patients, BMI correlated with the CSA (R = 0.294, P = 0.002). There was no significant difference in BMI, fat mass between the acromegalic and control group, but lean mass was higher in acromegalic patients compared with controls (54.8 ± 13.3 vs. 51 ± 11.6, P = 0.047). Lean mass and LMI (total body lean mass/height) positively correlated with CSA in acromegalic patients (R = 0.340, P < 0.001; R = 0.424, P < 0.001). No correlation was observed between fat mass and CSA of median nerve in all groups. We confirmed the enlargement of the median nerve in acromegalic patients. This enlargement is proportional to the degree of IGF-1 levels and is not dependent on the duration of the disease. The enlargement of the median nerve in acromegalic patients also depends on lean body mass and is not dependent on fat body mass.
- MeSH
- akromegalie diagnostické zobrazování MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- nervus medianus diagnostické zobrazování MeSH
- prospektivní studie MeSH
- senioři MeSH
- složení těla MeSH
- studie případů a kontrol MeSH
- ultrasonografie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Cieľ: Monitorovanie ultrasonograficky hodnotiteľných zmien nervus medianus v úrovni priečneho rezu karpálneho tunela u pacientov s hypotyreózou. Materiál a metódy: Prierezová kontrolovaná štúdia, v ktorej sme u pacientov s novodiagnostikovanou primárnou hypotyreózou vyšetrili plochu priečneho rezu nervus medianus v mieste jeho vstupu do karpálneho tunela (Cross Sectional Area; CSA). Hodnoty sme porovnali s kontrolnou skupinou zdravých jedincov. Rozdiel bol štatisticky vyhodnotený nepárovým t-testom. Výsledky: Zaradených bolo 44 pacientov (? vek 52,8 rokov, 14 mužov/30 žien, ? BMI 24,542 kg/m2, ? TSH (tyreotropín) 22,815 mIU/l, fT4 11,756 pmol/l). Kontrolná skupina pozostávala zo 44 jedincov (? vek 52,57 rokov, 14 mužov/30 žien, ? BMI 24,52 kg/m2, ? TSH 2,31 mIU/l, ? fT4 16,397 pmol/l). CSA bolo signifikantne väčšie u pacientov (? 0,098 cm2) v porovnaní s kontrolami (? 0,072 cm2, p < 0,001). U dvoch pacientov bolo zvýšenie hodnoty CSA (> 0,11 cm2) sprevádzané symptomatológiou syndrómu karpálneho tunela. Záver: Ultrasonografické nálezy u pacientov s primárnou hypotyreózou dokumentovali prítomnosť subklinického a klinického syndrómu karpálneho tunela. Ak je potvrdená prítomnosť syndrómu karpálneho tunela, je vhodné vyšetriť hladiny tyreoidálnych hormónov na vylúčenie možnej hypotyreózy. Meranie priečneho prierezu n. medianus pomocou ultrazvuku s vysokým rozlíšením by mohlo byť považované za alternatívnu modalitu pre včasný záchyt tejto neuropatie u pacientov s hypotyreózou.
Aim: The purpose of this study was to monitor ultrasound-detectable changes of median nerve in transverse section level of the carpal tunnel in hypothyroid patients with newly diagnosed, untreated autoimmune hypothyreosis. Material and methods: A cross sectional comparative study of patients with newly-diagnosed primary autoimunne hypothyroidism, where transverse section breadth of the median nerve in its entrance to the carpal tunnel (CSA) was measured. Values were compared with a control group of healthy subjects. Differences were statistically evaluated by unpaired t-test. Results: Absolute number of patients included in the study was 44 (? age 52.8 years, 14 males/30 females, ? BMI 24.542 kg/m2, ? TSH 22.815 mU/l, fT4 11.756 pmol/l). The control group consisted of 44 subjects (? age 52.57 years, 14 males/30 females, ? BMI 24.52 kg/m2, ? TSH 2.31 mU/l, ? fT4 16,397 pmol/l). CSA was significantly higher in patients (? 0.098 cm2) compared to controls (? 0.072 cm2, p < 0.001). In two hypothyroid patients, pathological increase of CSA (> 0.11 cm2) was in accordance with symptomatology of the carpal tunnel syndrome. Conclusion: Ultrasound findings documented occurrence of subclinical and clinical carpal tunnel syndrome in patients with primary hypothyroidism. If carpal tunnel syndrome occurs, thyroidal status should be evaluated to exclude possible hypothyroidism. Cross sectional area of median nerve evaluation with high frequency ultrasound could be considered an alternative modality for early detection of this neuropathy in patients with hypothyroidism.
- MeSH
- autoimunitní tyreoiditida * diagnóza komplikace MeSH
- hypotyreóza diagnóza etiologie komplikace MeSH
- index tělesné hmotnosti MeSH
- lidé středního věku MeSH
- lidé MeSH
- nervus medianus * ultrasonografie MeSH
- statistika jako téma MeSH
- studie případů a kontrol MeSH
- syndrom karpálního tunelu * diagnóza ultrasonografie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
