肩袖疾病的风险因素：糖尿病、高血压和高脂血症的系统评价和荟萃分析。
Risk factors for rotator cuff disease: A systematic review and meta-analysis of diabetes, hypertension, and hyperlipidemia.
机构信息
Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Division of Quantitative Sciences, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA.
University of Rochester School of Medicine, Rochester, NY, USA.
出版信息
Ann Phys Rehabil Med. 2023 Feb;66(1):101631. doi: 10.1016/j.rehab.2022.101631. Epub 2022 Nov 30.
BACKGROUND
Rotator cuff disease is a common cause of shoulder pain. Comorbidities such as diabetes, hypertension, and hyperlipidemia may be associated with rotator cuff disease, likely because of mechanisms related to vascular insufficiency.
OBJECTIVES
We performed a systematic review of the association of diabetes, hypertension, and hyperlipidemia with the diagnosis of rotator cuff disease.
METHODS
Following systematic queries of PubMed, Embase, Cochrane, CINAHL, and Science Direct, articles meeting eligibility criteria and reporting on the association of one or more risk factors (diabetes, hypertension, and hyperlipidemia) and rotator cuff disease were considered. Meta-analysis was performed to quantitatively summarize the associations between each risk factor and rotator cuff disease. We assessed study quality with the Newcastle-Ottawa Scale (NOS) and performed a qualitative assessment of risk of bias.
RESULTS
After a full-text review of 212 articles, 12 articles assessing diabetes, 5 assessing hypertension and 8 assessing hyperlipidemia were eligible. The odds of having rotator cuff disease was increased with diabetes (odds ratio [OR] 1.49, 95% confidence interval [CI] 1.43-1.55), hypertension (OR 1.40, 95% CI 1.19-1.65) and hyperlipidemia/dyslipidemia (OR 1.48, 95% CI 1.42-1.55). Diabetes was also specifically associated with rotator cuff tears (OR 1.28, 95% CI 1.07-1.52). Synthesizing assessment for risk of bias suggested that current epidemiologic evidence for an association was plausible for diabetes and hyperlipidemia but not hypertension.
CONCLUSIONS
Diabetes, hypertension, and hyperlipidemia were associated with rotator cuff disease in our meta-analysis. However, the possibility of bias exists for all 3 co-morbidities evaluated and is likely highest for hypertension. High-quality studies with the ability to incorporate time since first diagnosis of co-morbidity are scarce and much needed.
背景
肩袖疾病是肩部疼痛的常见原因。糖尿病、高血压和高血脂等合并症可能与肩袖疾病有关，这可能与血管功能不全相关的机制有关。
目的
我们对糖尿病、高血压和高血脂与肩袖疾病诊断的相关性进行了系统综述。
方法
在对 PubMed、Embase、Cochrane、CINAHL 和 Science Direct 进行系统查询后，纳入符合条件且报告了一种或多种危险因素（糖尿病、高血压和高血脂）与肩袖疾病相关性的文章。采用荟萃分析定量总结每种危险因素与肩袖疾病的相关性。我们使用纽卡斯尔-渥太华量表（NOS）评估研究质量，并对偏倚风险进行定性评估。
结果
在对 212 篇文章进行全文审查后，有 12 篇文章评估了糖尿病，5 篇评估了高血压，8 篇评估了高血脂。患有肩袖疾病的可能性随着糖尿病（比值比 [OR] 1.49，95%置信区间 [CI] 1.43-1.55）、高血压（OR 1.40，95% CI 1.19-1.65）和高血脂/血脂异常（OR 1.48，95% CI 1.42-1.55）而增加。糖尿病还与肩袖撕裂具体相关（OR 1.28，95% CI 1.07-1.52）。对偏倚风险的综合评估表明，目前关于糖尿病和高血脂与肩袖疾病相关性的流行病学证据是合理的，但高血压的可能性不大。对于评估的所有 3 种合并症，都存在偏倚的可能性，而高血压的可能性最大。目前非常需要高质量的研究，这些研究有能力纳入合并症首次诊断后的时间。
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