Trigger finger is associated with risk of incident cardiovascular disease in individuals with type 2 diabetes: a retrospective cohort study

Abstract

Introduction: Trigger finger is one of the complications affecting the upper extremity in patients with diabetes. Diabetes is also a well-known risk factor that predisposes individuals to cardiovascular diseases (CVDs). This retrospective cohort study aimed to establish the association between trigger finger and the patients with incident CVD with type 2 diabetes.

Materials and methods: Trigger finger was diagnosed by palpating a thickened tendon during flexion or on the manifestation of a locking phenomenon during extension or flexion of either finger. The relationship between trigger finger and other clinical parameters or complications of diabetes was examined by a comparative analysis. Cox regression analysis was used to evaluate the association between trigger finger and incidence of CVD. We calculated the propensity scores using sex, body mass index, age, smoking status, duration of diabetes, estimated glomerular filtration rate, hypertension, dyslipidemia, and hemoglobin A1c as the number of patients with incident CVD during the follow-up period was low.

Results: Among the 399 patients with type 2 diabetes, 54 patients had trigger finger. Patients with trigger finger were significantly older in age and had been suffering from diabetes for a longer duration. They also displayed worse renal function and glycemic control, along with a higher incidence of hypertension, neuropathy and nephropathy. During the average 5.66±1.12 years of follow-up, a total of 18 incidents occurred. According to the Cox regression analysis, trigger finger was shown to be associated with enhanced risk of the incidence of CVD after adjustment for the covariates (adjusted HR=3.33 (95% CI 1.25 to 8.66), p=0.017).

Conclusions: Trigger finger is associated with the risk of incident CVD in patients with type 2 diabetes. Thus, clinicians must consider these factors at the time of diagnosis of such patients.

Keywords: diabetes complications; macrovascular; type 2 diabetes.

Conflict of interest statement

Competing interests: YH received grants from Asahi Kasei Pharma outside the submitted work. MF received grants from Taisho Pharma Co, Daiichi Sankyo Co, MSD, Sumitomo Dainippon Pharma Co, Novo Nordisk Pharma, Kissei Pharma Co, Mitsubishi Tanabe Pharma Corp, Astellas Pharma, Nippon Boehringer Ingelheim Co, Sanwa Kagagu Kenkyusho Co, Tejin Pharma, Takeda Pharma Co, Sanofi, Kowa Pharma Co, Kyowa Kirin Co, Ono Pharma Co, Eli Lilly Japan, Nippon Chemiphar Co, Johnson & Johnson Medical Co, Abbott Japan Co, and Terumo Corp; and received honoraria from Mitsubishi Tanabe Pharma Corp, Sanofi, Novo Nordisk Pharma, MSD, AstraZeneca, Kowa Pharma Co, Ono Pharma Co, Sanwa Kagaku Kenkyusho Co, Mochida Pharma Co, Takeda Pharma Co, Astellas Pharma, Teijin Pharma, Sumitomo Dainippon Pharma Co, Daiichi Sankyo Co, Nippon Boehringer Ingelheim Co, Taisho Pharma Co, Bayer Yakuhin, Abbott Japan Co, Eli Lilly Japan, Medtronic Japan Co, Arkray, Kissei Pharma Co, Kyowa Kirin Co, and Nipro Corp outside the submitted work.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1

Probability of cumulative incident cardiovascular disease. Vertical axis represents cumulative incidence rate; horizontal axis represents days of incident cardiovascular disease. Blue line represents patients with trigger finger; red line represents patients without trigger finger.