Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Clinical Innovation & Research Center (CIRC), Shenzhen Hospital, Southern Medical University, Shenzhen, 518100, China.
BMC Musculoskelet Disord. 2024 Mar 19;25(1):220. doi: 10.1186/s12891-024-07345-w.
Emerging evidence has indicated the associations between subacromial impingement syndrome (SIS) of shoulder and lifestyle factors. However, whether unhealthy lifestyle factors causally increase SIS risk is not determined. This study aims to evaluate whether lifestyle factors are the risk factors of SIS.
A two-sample Mendelian randomization (MR) study was designed to evaluate the effect of 11 lifestyle factors on SIS risk. Causality was determined using the inverse-variance weighted method to calculate the odds ratio (OR) and establish a 95% confidence interval (CI). Weighted median method, MR-Egger method and MR-PRESSO method were conducted as sensitivity analysis.
Four lifestyle factors were identified causally associated with an increased risk of SIS using the IVW method: insomnia (OR: 1.66 95% CI 1.38, 2.00; P = 8.86 × 10), short sleep duration (OR: 1.53 95% CI 1.14, 2.05: P = 0.0043), mobile phone usage (OR: 4.65, 95% CI 1.59, 13.64; P = 0.0051), and heavy manual or physical work (OR: 4.24, 95% CI 2.17, 8.26; P = 2.20 × 10). Another causal but weak association was found between smoking initiation on SIS (OR: 1.17, 95% CI 1.01, 1.35; P = 3.50 × 10). Alcohol, coffee consumption, physical activity, sedentary behavior, sleep duration and computer usage were not found to be causally associated with an increased risk of SIS. Sensitivity analyses indicated that the MR estimates were robust and no heterogeneity and pleiotropy were identified in these MR analyses.
Sleep habits and shoulder usage were identified as causal factors for SIS. This evidence supports the development of strategies aimed at improving sleep behaviors and optimizing shoulder usage patterns as effective measures to prevent SIS.
越来越多的证据表明，肩峰下撞击综合征（SIS）与生活方式因素有关。然而，不健康的生活方式因素是否会导致 SIS 风险增加尚不确定。本研究旨在评估生活方式因素是否为 SIS 的危险因素。
设计了两样本孟德尔随机化（MR）研究，以评估 11 种生活方式因素对 SIS 风险的影响。使用逆方差加权法确定因果关系，计算比值比（OR）并建立 95%置信区间（CI）。使用加权中位数法、MR-Egger 法和 MR-PRESSO 法进行敏感性分析。
使用 IVW 法，有 4 种生活方式因素被确定为与 SIS 风险增加有关：失眠（OR：1.66，95%CI 1.38，2.00；P=8.86×10-4）、睡眠时间短（OR：1.53，95%CI 1.14，2.05；P=0.0043）、使用手机（OR：4.65，95%CI 1.59，13.64；P=0.0051）和重体力或体力劳动（OR：4.24，95%CI 2.17，8.26；P=2.20×10-4）。此外，还发现吸烟开始与 SIS 之间存在因果关系，但关联较弱（OR：1.17，95%CI 1.01，1.35；P=3.50×10-2）。饮酒、咖啡饮用、体力活动、久坐行为、睡眠时间和电脑使用与 SIS 风险增加无因果关系。敏感性分析表明，MR 估计值是稳健的，在这些 MR 分析中未发现异质性和多效性。
睡眠习惯和肩部使用被确定为 SIS 的因果因素。这一证据支持制定旨在改善睡眠行为和优化肩部使用模式的策略，作为预防 SIS 的有效措施。
