Gaida James E, Ashe Maureen C, Bass Shona L, Cook Jill L
School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia.
Arthritis Rheum. 2009 Jun 15;61(6):840-9. doi: 10.1002/art.24518.
Tendon injuries have been reported to occur more frequently in individuals with increased adiposity. Treatment also appears to have poorer outcomes among these individuals. Our objective was to examine the extent and consistency of associations between adiposity and tendinopathy.
A systematic review of observational studies was conducted. Eight electronic databases were searched (Allied and Complementary Medicine, Biological Abstracts, CINAHL, Current Contents, EMBase, Medline, SPORTDiscus, and Web of Science) and citation tracking was performed on included reports. Studies were included if they compared adiposity between subjects with and without tendon injury or examined adiposity as a predictor of conservative treatment success.
Four longitudinal cohorts, 14 cross-sectional studies, 8 case-control studies, and 2 interventional studies (28 in total) met the inclusion criteria, providing a total of 19,949 individuals. Forty-two subpopulations were identified, 18 of which showed elevated adiposity to be associated with tendon injury (43%). Sensitivity analyses indicated a clustering of positive findings among studies that included clinical patients (81% positive) and among case-control studies (77% positive).
Elevated adiposity is frequently associated with tendon injury. Published reports suggest that elevated adiposity is a risk factor for tendon injury, although this association appears to vary depending on aspects of study design and measurement. Adiposity is of particular interest in tendon research because, unlike a number of other reported risk factors for tendon injury, it is somewhat preventable and modifiable. Further research is required to determine if reducing adiposity will reduce the risk of tendon injury or improve the results of treatment.
据报道，肥胖个体的肌腱损伤更为常见。在这些个体中，治疗效果似乎也较差。我们的目的是研究肥胖与肌腱病之间关联的程度和一致性。
对观察性研究进行系统评价。检索了八个电子数据库（联合与补充医学数据库、生物学文摘数据库、护理学与健康领域数据库、现刊目次数据库、荷兰医学文摘数据库、医学索引数据库、体育与运动医学数据库和科学引文索引数据库），并对纳入报告进行了引文追踪。如果研究比较了有和没有肌腱损伤的受试者之间的肥胖情况，或者将肥胖作为保守治疗成功的预测因素进行研究，则纳入该研究。
四项纵向队列研究、十四项横断面研究、八项病例对照研究和两项干预性研究（共二十八项）符合纳入标准，共涉及19949名个体。确定了42个亚组，其中18个亚组显示肥胖增加与肌腱损伤相关（43%）。敏感性分析表明，在纳入临床患者的研究（81%为阳性）和病例对照研究（77%为阳性）中，阳性结果聚集。
肥胖增加常与肌腱损伤相关。已发表的报告表明，肥胖增加是肌腱损伤的危险因素，尽管这种关联似乎因研究设计和测量方面的不同而有所差异。肥胖在肌腱研究中特别受关注，因为与其他一些已报道的肌腱损伤危险因素不同，肥胖在一定程度上是可以预防和改变的。需要进一步研究以确定减轻肥胖是否会降低肌腱损伤风险或改善治疗效果。
