Burne Graham, Mansfield Michael, Gaida Jamie E, Lewis Jeremy S
Physiotherapy Department, Guy's and Saint Thomas' NHS Foundation Trust, London, UK.
Physiotherapy, University of Hertfordshire School of Health and Social Work, Hatfield, UK.
BMJ Open Sport Exerc Med. 2019 Dec 6;5(1):e000544. doi: 10.1136/bmjsem-2019-000544. eCollection 2019.
Rotator cuff-related shoulder pain (RCRSP) is a common upper limb complaint. It has been suggested that this condition is more common among people with cardiometabolic risk factors. This systematic review has synthesised evidence from case-control, cross-sectional and cohort studies on the association between metabolic syndrome (MetS) and RCRSP.
Five medical databases (MEDLINE, EMBASE, SCOPUS, CINAHL and AMED) and reference checking methods were used to identify all relevant English articles that considered MetS and RCRSP. Studies were appraised using the Newcastle-Ottawa Scale (NOS). Two reviewers performed critical appraisal and data extraction. Narrative synthesis was performed via content analysis of statistically significant associations.
Three cross-sectional, two case-control and one cohort study met the inclusion criteria, providing a total of 1187 individuals with RCRSP. Heterogeneity in methodology and RCRSP or MetS definition precluded a meaningful meta-analysis. Four of the included studies identified associations between the prevalence of MetS and RCRSP. Studies consistently identified independent cardiometabolic risk factors associated with RCRSP. All studies were level III evidence.
The low-moderate quality evidence included in this review suggests an association between MetS and RCRSP. Most studies demonstrated moderate quality on appraisal. The direction of association and cardiometabolic factors influencing should be investigated by longitudinal and treatment studies. These preliminary conclusions and clinical utility should be treated with caution due to limitations of the evidence base.
肩袖相关肩部疼痛（RCRSP）是一种常见的上肢疾病。有人认为，这种疾病在患有心脏代谢危险因素的人群中更为常见。本系统评价综合了病例对照研究、横断面研究和队列研究中关于代谢综合征（MetS）与RCRSP之间关联的证据。
使用五个医学数据库（MEDLINE、EMBASE、SCOPUS、CINAHL和AMED）以及参考文献核对方法，以识别所有考虑MetS和RCRSP的相关英文文章。使用纽卡斯尔-渥太华量表（NOS）对研究进行评估。两名评审员进行了批判性评价和数据提取。通过对具有统计学意义的关联进行内容分析进行叙述性综合。
三项横断面研究、两项病例对照研究和一项队列研究符合纳入标准，共纳入1187例RCRSP患者。方法学以及RCRSP或MetS定义的异质性使得有意义的荟萃分析无法进行。纳入的四项研究确定了MetS患病率与RCRSP之间的关联。研究一致确定了与RCRSP相关的独立心脏代谢危险因素。所有研究均为III级证据。
本评价纳入的低至中等质量证据表明MetS与RCRSP之间存在关联。大多数研究在评价中显示为中等质量。关联方向和影响的心脏代谢因素应通过纵向研究和治疗研究进行调查。由于证据基础的局限性，这些初步结论和临床实用性应谨慎对待。
