Prevalence of hand syndromes among patients with diabetes mellitus in Taiwan: A population‐based study

Background Population‐based data for diabetic hand syndrome (DHS) are limited. The aim of the present epidemiological study was to estimate the overall and cause‐specific prevalence and rate ratio (RR) of DHS in patients with diabetes. Methods The present study was a cross‐sectional study based on a random sample of 57 093 diabetics and matched controls, both identified from Taiwan National Health Insurance claims in 2010. The DHS analyzed in the present study included carpal tunnel syndrome (CTS), stenosing flexor tenosynovitis (SFT), limited joint mobility (LJM), and Dupuytren's disease (DD). Results The prevalence of overall DHS was estimated at 2472 per 105 for the diabetics, compared with 1641 per 105 for the controls, representing a prevalence RR of 1.51 (95 % confidence interval [CI] 1.39–1.64). Stratified analyses further revealed that the significantly increased prevalence of overall DHS was more evident in females than males (1.59 vs 1.36) and was only noted in diabetics aged ≥35 years. Cause‐specific analysis suggested that patients with diabetes had the highest prevalence of CTS (1244 per 105), followed by SFT (1209 per 105), LJM (39 per 105), and DD (6 per 105). In addition, diabetes was only significantly associated with CTS (RR 1.34; 95 % CI 1.20–1.51) and SFT (1.74; 95 % CI 1.54–1.97). Conclusion The prevalence of overall and certain cause‐specific DHS was significantly elevated in patients with diabetes in Taiwan. 背景 目前基于人群的糖尿病手综合征(diabetic hand syndrome,DHS)的数据还很有限。当前这项流行病学研究的目的是在糖尿病患者中评估总的以及特定病因的DHS患病率以及比值比(rate ratio,RR)。 方法 当前这项研究是一项基于随机样本的横断面研究,共包括57093名糖尿病患者以及配对的对照组,二者都筛选于2010年台湾地区全民健康保险索赔数据库。在当前这项研究中分析的DHS包括腕管综合征(carpal tunnel syndrome,CTS)、狭窄性屈指肌腱腱鞘炎(stenosing flexor tenosynoviti,SFT)、关节活动受限(limited joint mobility,LJM)以及掌腱膜挛缩症(Dupuytren’s disease,DD)。 结果 据估计糖尿病患者的DHS患病率为2472/105人,而对照组为1641/105人,这意味着患病率RR为1.51(95%置信区间[CI]为1.39–1.64)。进一步的分层分析后发现,女性与男性相比总DHS患病率增加更为显著(分别为1.59与1.36),并且只有在年龄≥ 35岁的糖尿病患者中才能观察到这种现象。特定病因分析结果提示,糖尿病患者的CTS患病率最高(1244/105人 ),接着是SFT(1209/105人)、LJM(39/105人)以及DD(6/105人)。另外,糖尿病只与CTS(RR为1.34;95% CI为1.20–1.51)以及SFT(1.74;95% CI为1.54–1.97)显著相关。 结论 台湾地区糖尿病患者总体以及某些特定病因的DHS患病率显著增加。 Highlights This is the first population‐based study reporting that the prevalence of diabetes hand syndrome (DHS) is 2.5 % in patients with diabetes, 51 % higher than in non‐diabetics. Stratified analysis indicated significant interactions of diabetes with age and sex on the prevalence of DHS. The prevalence of DHS was notably elevated in female