Department of Orthopaedics and Traumatology, Shoulder and Elbow Unit, Sapienza University, Rome, Italy.
Department of Orthopaedics and Traumatology, Shoulder and Elbow Unit, Sapienza University, Rome, Italy.
J Shoulder Elbow Surg. 2014 Nov;23(11):1669-74. doi: 10.1016/j.jse.2014.03.016. Epub 2014 Jun 4.
Rotator cuff tear (RCT) has a multifactorial etiology. We hypothesized that obesity may increase the risk of RCT and influence tear size.
A case-control design study was used. We studied 381 consecutive patients (180 men, 201 women; mean age ± standard deviation, 65.5 ± 8.52 years; range, 43-78 years) who underwent arthroscopic rotator cuff repair. Tear size was determined intraoperatively. The control group included 220 subjects (103 men, 117 women; mean age ± standard deviation, 65.16 ± 7.24 years; range, 42-77 years) with no RCT. Body weight, height, and bicipital, tricipital, subscapularis, and suprailiac skinfolds of all participants were measured to obtain body mass index (BMI) and the percentage of body fat (%BF). For the purposes of the study, the 601 participants were divided into 2 groups by BMI (group A, BMI ≥ 25; group B, BMI < 25). The odds ratios (ORs) were calculated to investigate whether adiposity affects the risk of RCT. Data were stratified according to gender and age. Multiple linear regression analyses were applied to explore the association between obesity and tear size.
The highest ORs for both men (OR, 2.49; 95% confidence interval, 1.41-3.90; P = .0037) and women (OR, 2.31; 95% confidence interval, 1.38-3.62; P = .0071) were for individuals with a BMI ≥ 30; 69% (N = 303) of group A and 48% (N = 78) of group B had RCTs. Patients with RCT had a BMI higher than that of subjects with no RCT in both groups (P = .031, group A; P = .02, group B). BMI and %BF significantly increased from patients with a small tear (BMI, 27.85; %BF, 37.63) to those with a massive RCT (BMI, 29.93; %BF, 39.43). Significant differences were found (P = .004; P = .031).
Our results provide evidence that obesity, measured through BMI and %BF, is a significant risk factor for the occurrence and severity of RCT.
肩袖撕裂(RCT)的病因是多因素的。我们假设肥胖可能会增加 RCT 的风险并影响撕裂的大小。
采用病例对照设计研究。我们研究了 381 例连续接受关节镜肩袖修复的患者(180 名男性,201 名女性;平均年龄±标准差,65.5±8.52 岁;年龄范围,43-78 岁)。术中确定撕裂的大小。对照组包括 220 名无 RCT 的受试者(103 名男性,117 名女性;平均年龄±标准差,65.16±7.24 岁;年龄范围,42-77 岁)。所有参与者的体重、身高、肱二头肌、三头肌、肩胛下肌和髂嵴皮褶均进行测量,以获得体重指数(BMI)和体脂百分比(%BF)。为了研究的目的,根据 BMI 将 601 名参与者分为 2 组(A 组,BMI≥25;B 组,BMI<25)。计算比值比(OR)以调查肥胖是否会影响 RCT 的风险。根据性别和年龄对数据进行分层。应用多元线性回归分析来探讨肥胖与撕裂大小之间的关系。
对于男性(OR,2.49;95%置信区间,1.41-3.90;P=0.0037)和女性(OR,2.31;95%置信区间,1.38-3.62;P=0.0071),BMI≥30 的个体的 OR 最高;A 组 69%(N=303)和 B 组 48%(N=78)的个体患有 RCT。两组中患有 RCT 的患者的 BMI 均高于无 RCT 的患者(P=0.031,A 组;P=0.02,B 组)。从撕裂较小的患者(BMI,27.85;%BF,37.63)到撕裂较大的患者(BMI,29.93;%BF,39.43),BMI 和%BF 显著增加。发现有显著差异(P=0.004;P=0.031)。
我们的研究结果表明,肥胖(通过 BMI 和%BF 衡量)是 RCT 的发生和严重程度的重要危险因素。