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肥胖与肩袖撕裂中的肌肉萎缩有关。

Obesity is associated with muscle atrophy in rotator cuff tear.

作者信息

Herzberg Simone D, Zhao Zhiguo, Freeman Thomas H, Prakash Ravi, Baumgarten Keith M, Bishop Julie Y, Carey James L, Jones Grant L, McCarty Eric C, Spencer Edwin E, Vidal Armando F, Jain Nitin B, Giri Ayush, Kuhn John E, Khazzam Michael S, Matzkin Elizabeth G, Brophy Robert H, Dunn Warren R, Ma C Benjamin, Marx Robert G, Poddar Sourav K, Smith Matthew V, Wolf Brian R, Wright Rick W

机构信息

Epidemiology, Vanderbilt University, Nashville, Tennessee, USA.

School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

出版信息

BMJ Open Sport Exerc Med. 2024 Jun 28;10(2):e001993. doi: 10.1136/bmjsem-2024-001993. eCollection 2024.

Abstract

OBJECTIVE

The primary goal of this study is to evaluate the relationship between Body Mass Index (BMI) and muscle atrophy in individuals with rotator cuff tears.

METHODS

This study consists of patients with rotator cuff tears identified by MRI from two independent cohorts, the Rotator Cuff Outcomes Workgroup (ROW) and the Multicenter Orthopaedic Outcomes Network (MOON). Presence of atrophy (yes/no) and severity of atrophy (as an ordinal variable) were assessed on MRI by expert physicians. We used multivariable regression models to evaluate the relationship between BMI and muscle atrophy while adjusting for age and sex in each study, conducted sensitivity analyses for full-thickness tear and combined results using inverse variance-weighted meta-analysis.

RESULTS

A total of 539 patients (MOON=395, ROW=144) from the combined cohorts had MRI data available on muscle atrophy. Among these patients, 246 (46%) had atrophy of at least one of the muscles of the rotator cuff and 282 (52%) had full-thickness tears. In meta-analysis across both cohorts, each 5 kg/m increase in BMI was associated with a 21% (aOR=1.21, 95% CI=1.02, 1.43) increased odds of having muscle atrophy among individuals with any tear size, and 36% (aOR=1.36, 95% CI=1.01-1.81) increased odds among individuals with full-thickness tear.

CONCLUSIONS

Higher BMI was associated with significantly higher odds of muscle atrophy in patiens with rotator cuff tears. More study is needed to unders1tand why and how this relationship exists, as well as whether interventions to reduce BMI may help improve outcomes for these patients.

LEVEL OF EVIDENCE

III.

摘要

目的

本研究的主要目的是评估肩袖撕裂患者的体重指数(BMI)与肌肉萎缩之间的关系。

方法

本研究纳入了通过MRI从两个独立队列(肩袖结局工作组(ROW)和多中心骨科结局网络(MOON))中确定的肩袖撕裂患者。由专业医生在MRI上评估萎缩的存在(是/否)和萎缩的严重程度(作为有序变量)。我们使用多变量回归模型来评估BMI与肌肉萎缩之间的关系,同时在每项研究中对年龄和性别进行调整,对全层撕裂进行敏感性分析,并使用逆方差加权荟萃分析合并结果。

结果

合并队列中的539例患者(MOON = 395例,ROW = 144例)有关于肌肉萎缩的MRI数据。在这些患者中,246例(46%)至少有一块肩袖肌肉出现萎缩,282例(52%)为全层撕裂。在两个队列的荟萃分析中,BMI每增加5 kg/m²,任何撕裂大小的个体发生肌肉萎缩的几率增加21%(调整后比值比[aOR]=1.21,95%置信区间[CI]=1.02,1.43),全层撕裂个体的几率增加36%(aOR = 1.36,95% CI = 1.01 - 1.81)。

结论

较高的BMI与肩袖撕裂患者肌肉萎缩的几率显著升高相关。需要更多的研究来了解这种关系存在的原因和方式,以及降低BMI的干预措施是否有助于改善这些患者的结局。

证据级别

III级。

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