Huang Shih-Wei, Wang Wei-Te, Chou Lin-Chuan, Liou Tsan-Hon, Chen Yi-Wen, Lin Hui-Wen
Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taiwan.
Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua, Taiwan.
J Diabetes Complications. 2016 Nov-Dec;30(8):1473-1477. doi: 10.1016/j.jdiacomp.2016.07.015. Epub 2016 Jul 25.
Rotator cuff tears are the most common cause of shoulder disability in people older than 50years, and surgical intervention is usually required for restoring functioning. However, in patients undergoing rotator cuff repair surgery, patients with DM had poorer functional outcomes than those without DM, and hence, DM is one of the possible risks factor for rotator cut off tear. The aim of this population-based study was to investigate the relationship between DM and the risk of rotator cuff tear in patients receiving rotator cuff repair surgery.
In this retrospective longitudinal population-based 7-year cohort study, we investigated the risk of rotator cuff repair surgery in patients with DM. We performed a case-control matched analysis by using data from the Taiwan Longitudinal Health Insurance Database 2005. Patients were enrolled on the basis of the International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes for DM between January 1, 2004, and December 31, 2007. The prevalence and the adjusted hazard ratios (HRs) of a rotator cuff repair surgery in patients with and without DM were estimated according to the Cox proportional hazard regression analysis using the frailty model.
The DM and non-DM cohorts comprised 58,652 patients with DM and 117,304 (1:2) patients without DM after matching for age and sex. The incidence of rotator cuff repair surgery was 41 per 100,000 and 26 per 100,000 person-years in the DM and non-DM cohorts, respectively. The HR of rotator cuff repair surgery during the follow-up period was 1.56 (95% confidence interval [CI] 1.25-1.93, p<0.001) for patients with DM. After adjustment for covariates, the adjusted HR of rotator cuff repair surgery was 1.33 (95% CI, 1.05-1.68, p<0.001) in the DM cohort.
DM is an independent risk factor for rotator cuff tear repair surgery.
肩袖撕裂是50岁以上人群肩部功能障碍的最常见原因，通常需要手术干预来恢复功能。然而，在接受肩袖修复手术的患者中，糖尿病患者的功能结局比非糖尿病患者更差，因此，糖尿病是肩袖撕裂的可能风险因素之一。这项基于人群的研究旨在调查糖尿病与接受肩袖修复手术患者肩袖撕裂风险之间的关系。
在这项回顾性纵向基于人群的7年队列研究中，我们调查了糖尿病患者肩袖修复手术的风险。我们使用2005年台湾纵向健康保险数据库的数据进行病例对照匹配分析。患者根据2004年1月1日至2007年12月31日期间国际疾病分类第九版临床修订版糖尿病诊断代码进行登记。根据使用脆弱模型的Cox比例风险回归分析，估计糖尿病患者和非糖尿病患者肩袖修复手术的患病率和调整后的风险比（HR）。
糖尿病组和非糖尿病组在年龄和性别匹配后分别包括58,652例糖尿病患者和117,304例（1:2）非糖尿病患者。糖尿病组和非糖尿病组肩袖修复手术的发生率分别为每10万人年41例和26例。糖尿病患者在随访期间肩袖修复手术的HR为1.56（95%置信区间[CI]1.25-1.93，p<0.001）。在对协变量进行调整后，糖尿病组肩袖修复手术的调整后HR为1.33（95%CI，1.05-1.68，p<0.001）。
糖尿病是肩袖撕裂修复手术的独立风险因素。
