Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
J Shoulder Elbow Surg. 2013 Nov;22(11):1547-51. doi: 10.1016/j.jse.2013.01.011. Epub 2013 Mar 22.
Diabetic patients have a high prevalence of shoulder pain and stiffness. Interleukin (IL) 1β was reportedly correlated with shoulder stiffness and decreased shoulder function. We retrospectively compared the expression of IL-1β in the subacromial synovial fluid between diabetic and nondiabetic patients with rotator cuff tearing.
We enrolled 68 patients with rotator cuff tearing (23 diabetic patients and 45 nondiabetic patients). The preoperative sum of range-of-motion deficit (SROMD), Constant score, and visual analog scale (VAS) score were obtained. Intraoperatively, subacromial synovial fluid was collected for the IL-1β level measurement. Comparisons of IL-1β levels, Constant scores, SROMD, and VAS scores between diabetic and nondiabetic patients were analyzed with the Mann-Whitney U test.
Diabetic patients with rotator cuff tearing had significantly increased subacromial IL-1β levels (P = .048), SROMD (P < .001) and VAS scores (P = .022) and lower Constant scores (P < .001) than nondiabetic patients. The IL-1β levels in the subacromial fluid were significantly correlated with the Constant score (r = -0.477, P < .001), VAS score (r = 0.698, P < .001), and SROMD (r = 0.293, P = .015) in all patients.
The elevated IL-1β levels in the subacromial fluid of patients with diabetes may explain the likelihood of pain and shoulder stiffness developing in these patients. We suggest more aggressive treatment for rotator cuff lesions in diabetic patients.
糖尿病患者肩痛和僵硬的发生率较高。据报道,白细胞介素(IL)1β与肩部僵硬和肩部功能下降有关。我们回顾性比较了肩袖撕裂的糖尿病和非糖尿病患者肩峰下滑液中 IL-1β的表达。
我们纳入了 68 例肩袖撕裂患者(23 例糖尿病患者和 45 例非糖尿病患者)。术前获得了总活动度缺陷(SROMD)、Constant 评分和视觉模拟评分(VAS)。术中采集肩峰下滑液,用于测量 IL-1β 水平。采用 Mann-Whitney U 检验比较糖尿病和非糖尿病患者的 IL-1β 水平、Constant 评分、SROMD 和 VAS 评分。
与非糖尿病患者相比,糖尿病肩袖撕裂患者肩峰下 IL-1β 水平显著升高(P =.048)、SROMD 显著升高(P <.001)、VAS 评分显著升高(P =.022),Constant 评分显著降低(P <.001)。肩峰下滑液中的 IL-1β 水平与 Constant 评分(r = -0.477,P <.001)、VAS 评分(r = 0.698,P <.001)和 SROMD(r = 0.293,P =.015)呈显著相关。
糖尿病患者肩峰下滑液中升高的 IL-1β 水平可能解释了这些患者发生疼痛和肩部僵硬的可能性。我们建议对糖尿病患者的肩袖病变进行更积极的治疗。