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肌肉减少症与社区居住老年人肩袖肌腱疾病风险增加相关:一项横断面定量超声研究

Sarcopenia Is Associated With Increased Risks of Rotator Cuff Tendon Diseases Among Community-Dwelling Elders: A Cross-Sectional Quantitative Ultrasound Study.

作者信息

Han Der-Sheng, Wu Wei-Ting, Hsu Po-Cheng, Chang Hsiang-Chi, Huang Kuo-Chin, Chang Ke-Vin

机构信息

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan.

Community and Geriatric Medicine Research Center, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan.

出版信息

Front Med (Lausanne). 2021 May 5;8:630009. doi: 10.3389/fmed.2021.630009. eCollection 2021.

Abstract

Recently, the association between sarcopenia and various musculoskeletal disorders, such as lumbar spine stenosis and fibromyalgia, has been highlighted. However, the relationship between sarcopenia and rotator cuff tendon diseases has rarely been investigated. This study aimed to evaluate whether sarcopenia was associated with shoulder pain and to determine whether rotator cuff tendons differed in echotexture between the sarcopenic and non-sarcopenic populations. The thickness and echogenicity ratio of the tendon vs. the overlying muscle (ER) or subcutaneous tissue (ER) were measured using high-resolution ultrasonography in 56 sarcopenic patients and 56 sex- and age- matched controls. The association between ultrasound measurements of the rotator cuff tendon complex and sarcopenia was investigated using the generalized estimating equation (GEE). The sarcopenic group had an increased prevalence of shoulder pain. Based on the GEE analysis, sarcopenia was significantly associated with an increase in supraspinatus tendon thickness (β coefficient = 0.447, < 0.001) and a decrease in the ER for the biceps long head and rotator cuff tendons. A negative trend of association was observed between sarcopenia and ER in the supraspinatus tendons (β coefficient = -0.097, = 0.070). Nevertheless, sarcopenia was not associated with an increased risk of rotator cuff tendon tears. Patients with sarcopenia have a higher risk of shoulder pain. A consistent tendinopathic change develops in the supraspinatus tendons in sarcopenic patients. However, sarcopenia is less likely to be associated with serious rotator cuff pathology, such as tendon tears. Prospective cohort studies are warranted to explore the causal relationship between sarcopenia and shoulder disorders.

摘要

最近,肌肉减少症与各种肌肉骨骼疾病(如腰椎管狭窄症和纤维肌痛)之间的关联已受到关注。然而,肌肉减少症与肩袖肌腱疾病之间的关系鲜有研究。本研究旨在评估肌肉减少症是否与肩部疼痛相关,并确定肌肉减少症患者与非肌肉减少症患者的肩袖肌腱在回声纹理上是否存在差异。使用高分辨率超声对56例肌肉减少症患者和56例性别及年龄匹配的对照者测量肌腱相对于其上覆盖肌肉(ER)或皮下组织(ER)的厚度和回声率。使用广义估计方程(GEE)研究肩袖肌腱复合体的超声测量值与肌肉减少症之间的关联。肌肉减少症组肩部疼痛的患病率更高。基于GEE分析,肌肉减少症与冈上肌腱厚度增加(β系数 = 0.447,<0.001)以及肱二头肌长头和肩袖肌腱的ER降低显著相关。在冈上肌腱中观察到肌肉减少症与ER之间存在负相关趋势(β系数 = -0.097,= 0.070)。然而,肌肉减少症与肩袖肌腱撕裂风险增加无关。肌肉减少症患者肩部疼痛风险更高。肌肉减少症患者的冈上肌腱会出现一致的肌腱病变改变。然而,肌肉减少症不太可能与严重的肩袖病变(如肌腱撕裂)相关。有必要进行前瞻性队列研究以探讨肌肉减少症与肩部疾病之间的因果关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34d5/8131871/6b23864ae21f/fmed-08-630009-g0001.jpg

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