Weng Pei-Wei, Chang Wen-Pei
Department of Orthopaedics, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan.
School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
J Shoulder Elbow Surg. 2024 Mar;33(3):648-656. doi: 10.1016/j.jse.2023.07.007. Epub 2023 Oct 31.
Research on the relationship between obesity and rotator cuff tears (RCTs) has been limited to the impact of obesity on the results of arthroscopic repair of RCTs; thus, a need for rigorous research controlling for other factors affecting RCTs is warranted, especially to better understand the impact of body mass index (BMI) on RCT severity.
A retrospective study of admission records contained in electronic medical records pertaining to patients who were admitted for RCT repair on 1 shoulder between January 2018 and July 2022 was conducted. In total, 386 patients were included. In accordance with guidance regarding obesity from Taiwan's Ministry of Health and Welfare, patients were divided into three groups: underweight or normal weight (BMI <24.0 kg/m), overweight (BMI 24.0-26.9 kg/m), or obese (BMI ≥27.0 kg/m). Magnetic resonance imaging was used to assess RCT severity in terms of four parameters: Patte stage (PS), fatty infiltration (FI), anteroposterior tear size (AP), and retraction size. Multinomial logistic regression analysis was performed on PS and FI grade data, and multiple linear regression analysis was performed on AP tear size and retraction size in order to analyze impact.
Our results revealed that the average age of the 386 patients was 63.41 years (SD = 9.29) and the mean BMI was 25.88 (SD = 3.72) kg/m. We found significant differences in PS (P = .003), FI (P < .001), retraction size (P = .001), and AP tear size (P = .001) among patients who were underweight or normal weight, overweight, and obese. After controlling for other risk factors, including age, gender, RCT-prone occupation, duration of shoulder pain prior to surgery, history of shoulder injury, and tobacco use, we found that obese patients had higher severity levels in PS (B = 1.21, OR = 3.36, P = .029), FI (B = 1.38, OR = 3.96, P < .001), retraction size (β = 0.18, P = .001), and AP tear size (β = 0.18, P = .001) compared to underweight or normal weight patients.
Our study demonstrates that a correlation exists between BMI-measured obesity and RCT severity. We therefore suggest that adults control their weight given that maintaining a healthy weight is highly associated with better shoulder health.
肥胖与肩袖撕裂（RCT）之间关系的研究仅限于肥胖对RCT关节镜修复结果的影响；因此，有必要进行严格的研究以控制影响RCT的其他因素，特别是为了更好地理解体重指数（BMI）对RCT严重程度的影响。
对2018年1月至2022年7月期间因一侧肩部RCT修复入院的患者电子病历中的入院记录进行回顾性研究。共纳入386例患者。根据台湾卫生福利部关于肥胖的指导方针，将患者分为三组：体重过轻或正常体重（BMI<24.0kg/m）、超重（BMI 24.0-26.9kg/m）或肥胖（BMI≥27.0kg/m）。采用磁共振成像从四个参数评估RCT严重程度：帕特分期（PS）、脂肪浸润（FI）、前后撕裂大小（AP）和回缩大小。对PS和FI分级数据进行多项逻辑回归分析，对AP撕裂大小和回缩大小进行多元线性回归分析以分析影响。
我们的结果显示，386例患者的平均年龄为63.41岁（标准差=9.29），平均BMI为25.88（标准差=3.72）kg/m。我们发现体重过轻或正常体重、超重和肥胖患者在PS（P=0.003）、FI（P<0.001）、回缩大小（P=0.001）和AP撕裂大小（P=0.001）方面存在显著差异。在控制了其他风险因素，包括年龄、性别、易患RCT的职业、手术前肩部疼痛持续时间、肩部损伤史和吸烟情况后，我们发现与体重过轻或正常体重的患者相比，肥胖患者在PS（B=1.21，OR=3.36，P=0.029）、FI（B=1.38，OR=3.96，P<0.001）、回缩大小（β=0.18，P=0.001）和AP撕裂大小（β=0.18，P=
