Tighe Connie B, Oakley Ward S
Orthopaedic and Joint Replacement Center, Pinehurst Surgical, PA, Pinehurst, NC, USA.
South Med J. 2008 Jun;101(6):591-5. doi: 10.1097/SMJ.0b013e3181705d39.
Adhesive capsulitis is characterized by a progressive and painful loss of shoulder motion of unknown etiology. Previous studies have found the prevalence of adhesive capsulitis to be slightly greater than 2% in the general population. However, the relationship between adhesive capsulitis and diabetes mellitus (DM) is well documented, with the incidence of adhesive capsulitis being two to four times higher in diabetics than in the general population. It affects about 20% of people with diabetes and has been described as the most disabling of the common musculoskeletal manifestations of diabetes.
Consented patients presenting with adhesive capsulitis reporting no history of DM had blood testing for diabetes and prediabetes. An anonymous database was analyzed for a diabetic condition.
The prevalence of diabetes in patients with adhesive capsulitis was 38.6% (34 of 88). The prevalence of prediabetes was 32.95% (29 of 88). The total prevalence of a diabetic condition in patients with adhesive capsulitis was 71.5% (63 of 88). Previous literature fails to reveal the incidence of newly diagnosed diabetes, 2 of 88 (2%), and prediabetes, 25 of 88 (28.4%) in patients presenting with adhesive capsulitis. Early diagnosis and effective management of DM reduces the risk of microvascular complications. DM is believed to play a role in the development of musculoskeletal complications.
Awareness of these findings alerts the practitioner to the risk of diabetes and prediabetes in patients presenting with adhesive capsulitis of the shoulder.
粘连性关节囊炎的特征是肩部活动逐渐丧失且疼痛,病因不明。既往研究发现,粘连性关节囊炎在普通人群中的患病率略高于2%。然而,粘连性关节囊炎与糖尿病(DM)之间的关系已有充分记录,糖尿病患者中粘连性关节囊炎的发病率是普通人群的两到四倍。它影响约20%的糖尿病患者,被认为是糖尿病常见肌肉骨骼表现中最致残的一种。
同意参与研究的粘连性关节囊炎患者,若报告无糖尿病病史,则进行糖尿病和糖尿病前期的血液检测。对一个匿名数据库进行糖尿病情况分析。
粘连性关节囊炎患者中糖尿病的患病率为38.6%(88例中的34例)。糖尿病前期的患病率为32.95%(88例中的29例)。粘连性关节囊炎患者中糖尿病状态的总患病率为71.5%(88例中的63例)。既往文献未揭示粘连性关节囊炎患者中新诊断糖尿病的发病率,88例中有2例(2%),以及糖尿病前期的发病率,88例中有25例(28.4%)。糖尿病的早期诊断和有效管理可降低微血管并发症的风险。糖尿病被认为在肌肉骨骼并发症的发生中起作用。
对这些发现的认识提醒从业者,患有肩部粘连性关节囊炎的患者存在患糖尿病和糖尿病前期的风险。