Relationships between serum mercaptoalbumin/non-mercaptoalbumin ratio, 25(OH)D level, symptom severity, functional status and median nerve cross-sectional area in carpal tunnel syndrome
2 Department of Biochemistry, University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Türkiye
3 Department of Public Health, University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Türkiye DOI : 10.5606/tftrd.2025.15426 Objectives: This study aims to investigate mercaptoalbumin and non-mercaptoalbumin (HNA%) levels in the serum of patients with idiopathic carpal tunnel syndrome (CTS) and to explore the correlation between serum HNA% and symptom severity, functional status, electrophysiological findings (EPFs), median nerve cross-sectional area (MNCSA) measured by ultrasound, and vitamin D levels.
Patients and methods: Between April 2022 and November 2023, this prospective, case-controlled study included a total of 47 patients diagnosed with bilateral CTS (6 males, 41 females; mean age: 45.4±9.0 years; range, 25 to 60 years) and 34 healthy controls (4 males, 30 females; mean age: 42.5±10.8 years; range, 27 to 60 years) were included. Evaluation parameters included pain as measured by Visual Analog Scale (VAS), pinch grip strength (kg), Boston Carpal Tunnel Questionnaire (BCTQ), EPF, MNCSA by ultrasonography (mm2), mercaptoalbumin and non-mercaptoalbumin ratio in serum (HNA%=HNA /Total albumin ×100) and 25(OH)D.
Results: The MNCSA was significantly higher in patients with CTS than healthy controls (p<0.001). The HNA% was significantly higher and 25(OH)D levels were significantly lower in patients with CTS than in healthy controls (p<0.001 and p=0.003, respectively). The HNA% was positively correlated symptom severity score (SSS) and functional status score (FSS) (r=0.396, p=0.006; r=0.29, p=0.042, respectively), and negatively correlated with 25(OH)D (r=–0.320, p=0.028). There was no relationship between HNA% and EPF and MNCSA.
Conclusion: Our study results suggest that HNA% may be a new biomarker of oxidative stress in CTS. There is a relationship between HNA% and symptom severity, functional status, and low vitamin D levels.
Keywords : Carpal tunnel syndrome, median nerve cross-sectional area, non-mercaptoalbumin ratio, oxidative stress, vitamin D