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Hyperglycaemia is a causal risk factor for upper limb pathologies.
- Source :
-
International journal of epidemiology [Int J Epidemiol] 2024 Feb 01; Vol. 53 (1). - Publication Year :
- 2024
-
Abstract
- Background: Diabetes (regardless of type) and obesity are associated with a range of musculoskeletal disorders. The causal mechanisms driving these associations are unknown for many upper limb pathologies. We used genetic techniques to test the causal link between glycemia, obesity and musculoskeletal conditions.<br />Methods: In the UK Biobank's unrelated European cohort (N = 379 708) we performed mendelian randomisation (MR) analyses to test for a causal effect of long-term high glycaemia and adiposity on four musculoskeletal pathologies: frozen shoulder, Dupuytren's disease, carpal tunnel syndrome and trigger finger. We also performed single-gene MR using rare variants in the GCK gene.<br />Results: Using MR, we found evidence that long-term high glycaemia has a causal role in the aetiology of upper limb conditions. A 10-mmol/mol increase in genetically predicted haemoglobin A1C (HbA1c) was associated with frozen shoulder: odds ratio (OR) = 1.50 [95% confidence interval (CI), 1.20-1.88], Dupuytren's disease: OR = 1.17 (95% CI, 1.01-1.35), trigger finger: OR = 1.30 (95% CI, 1.09-1.55) and carpal tunnel syndrome: OR = 1.20 (95% CI, 1.09-1.33). Carriers of GCK mutations have increased odds of frozen shoulder: OR = 7.16 (95% CI, 2.93-17.51) and carpal tunnel syndrome: OR = 2.86 (95% CI, 1.50-5.44) but not Dupuytren's disease or trigger finger. We found evidence that an increase in genetically predicted body mass index (BMI) of 5 kg/m2 was associated with carpal tunnel syndrome: OR = 1.13 (95% CI, 1.10-1.16) and associated negatively with Dupuytren's disease: OR = 0.94 (95% CI, 0.90-0.98), but no evidence of association with frozen shoulder or trigger finger. Trigger finger (OR 1.96 (95% CI, 1.42-2.69) P = 3.6e-05) and carpal tunnel syndrome [OR 1.63 (95% CI, 1.36-1.95) P = 8.5e-08] are associated with genetically predicted unfavourable adiposity increase of one standard deviation of body fat.<br />Conclusions: Our study consistently demonstrates a causal role of long-term high glycaemia in the aetiology of upper limb musculoskeletal conditions. Clinicians treating diabetes patients should be aware of these complications in clinic, specifically those managing the care of GCK mutation carriers. Upper limb musculoskeletal conditions should be considered diabetes complications.<br /> (© The Author(s) 2024. Published by Oxford University Press on behalf of the International Epidemiological Association.)
- Subjects :
- Humans
Upper Extremity
Risk Factors
Obesity complications
Obesity epidemiology
Obesity genetics
Dupuytren Contracture epidemiology
Dupuytren Contracture genetics
Dupuytren Contracture complications
Carpal Tunnel Syndrome epidemiology
Carpal Tunnel Syndrome genetics
Carpal Tunnel Syndrome complications
Trigger Finger Disorder complications
Hyperglycemia complications
Hyperglycemia epidemiology
Hyperglycemia genetics
Musculoskeletal Diseases complications
Diabetes Mellitus
Bursitis complications
Subjects
Details
- Language :
- English
- ISSN :
- 1464-3685
- Volume :
- 53
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- International journal of epidemiology
- Publication Type :
- Academic Journal
- Accession number :
- 38205890
- Full Text :
- https://doi.org/10.1093/ije/dyad187