Comparison of vitamin D, vitamin b12 and folic acid levels in patients with carpal tunnel syndrome

Introduction: Carpal Tunnel Syndrome (CTS) is a clinical picture resulting from compression of the median nerve in the carpal tunnel. In this study, it was aimed to determine the level of vitamin D, vitamin B12 and folic acid in patients diagnosed with carpal tunnel syndrome clinically and electrophysiologically and to reveal its relationship with disease severity. Materials and Methods: The study included 100 patients between 18-70 years, clinically and electrophysiologically diagnosed as CTS, and 40 clinical and electrophysiologically normal control groups. Patients diagnosed with clinical and superficial electromyography (EMG) were divided into 3 groups as mild, moderate and severe CTS. Patients were evaluated clinically with the Visual Pain Scale (VAS), Boston Carpal Tunnel Syndrome Questionnaire and The Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale. As a preliminary diagnosis, CTS was considered, but patients whose superficial EMG results did not comply with CTS were taken as the control group after excluding diseases and conditions in the exclusion criteria. Vitamin D, vitamin B12 and folic acid blood levels were examined in all individuals in the patient and control groups. It was investigated whether there was a significant difference between patient groups (mild, moderate, severe) and control group (superficial EMG normal) in terms of vitamin D, vitamin B12 and folic acid levels. Results: There were 84 female (%84) and 16 male (%16) patients in the case group and the mean age of the case group was 52.65±11.74. Symptom duration of 30 patients was less than 1 year, 54 patients were between 1-5 years and 16 patients had clinical symptoms longer than 5 years. As a result of clinical, physical examination, and electrophysiological studies, 30 patients were diagnosed with mild, 49 patients with moderate and 21 patients with severe CTS. The mean vitamin D level of the case group was 16±10.86, the average level of vitamin B12 was 343.37±163.80, the average of folic acid level was 8.58±3.88. In the control group, these values are 16.33±11.66, 328.32±121.46 ve 8.27±2.79 respectively. Vitamin D, vitamin B12 and folic acid levels were compared between the case group and the control group and no statistically significant difference was found (p> 0.05). However, vitamin D was found at low levels in all groups and was found at lower levels, although not statistically significant in the case group. Also, vitamin B12 levels were found to be lower in the case group, although not statistically significant. Between the duration of clinical symptoms and the severity of CTS; a positive correlation was found between the VAS score, Boston symptom severity scale score, and LANSS pain scale score and CTS severity, which was statistically significant. (P <0.05) Conclusion: Vitamin D deficiency is a very common problem and produces various clinical results. In patients presenting with symptoms such as pain in the hands, numbness and tingling, vitamin D and B12 vitamin levels should also be evaluated. Keywords: Carpal Tunnel Syndrome, Vitamin D, Vitamin B12, Folic Acid, Neuropathy