The epidemiology of cubital tunnel syndrome: a UK Biobank case-control study

Cubital tunnel syndrome is the second most prevalent upper limb compression neuropathy. Limitations in non-operative and surgical treatment warrant an adjunctive preventative approach targeting modifiable risk factors. However, risk factors are poorly characterized given methodologic shortcomings in previous studies.

In this case-control study in the UK Biobank (1971 cases, 398,639 controls), multivariable logistic regression with extensive covariate correction was conducted to assess the association between cubital tunnel syndrome and sex, age, ethnicity, socioeconomic deprivation, smoking status, alcohol intake, height, body mass index, plasma lipids, HbA1c, diabetes, hypertension, carpal tunnel syndrome, osteoarthritis, rheumatoid arthritis, hypothyroidism and gastroesophageal reflux disease.

Cubital tunnel syndrome was significantly associated with several modifiable risk factors: smoking status (odds ratio 2.08, 95% CI: 1.83-2.37), diabetes with microvascular complications (OR 1.80, 95% CI: 1.40-2.30), hypertension (OR 1.37, 95% CI: 1.24-1.52) and raised body mass index (OR 1.13, 95% CI: 1.08-1.19). Male sex (OR 1.77, 95% CI: 1.54-2.04) and age (OR 0.981, 95% CI: 0.975-0.986) were non-modifiable risk factors. Several comorbidities were associated with cubital tunnel syndrome: carpal tunnel syndrome (OR 11.7, 95% CI: 10.6-12.9), osteoarthritis (OR 2.12, 95% CI: 1.92-2.34), rheumatoid arthritis (OR 1.72, 95% CI: 1.42-2.07), and gastroesophageal reflux disease (OR 1.66, 95% CI: 1.50-1.83). Cubital tunnel syndrome had a weak association with socioeconomic deprivation and no association with ethnicity, height, alcohol intake, plasma lipids, HbA1c and hypothyroidism.

Cubital tunnel syndrome is robustly associated with several modifiable risk factors that may be targeted in primary and secondary prevention.

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