Herzberg Simone D, Garriga Gustavo A, Jain Nitin B, Giri Ayush
Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A.
Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A.
Arthrosc Sports Med Rehabil. 2024 May 31;6(4):100953. doi: 10.1016/j.asmr.2024.100953. eCollection 2024 Aug.
To analyze the literature regarding obesity, body mass index (BMI), and rotator cuff disease (RCD).
In this Systematic Review and Meta-analysis, we queried PubMed, Embase, Cochrane, Cumulative Index to Nursing & Allied Health, and Science Direct using key words (August 25, 2023). Analytic observational studies (cohort, case-control, and cross-sectional studies) with more than 30 participants per comparison group, evaluating the association between obesity and rotator cuff pathology, were eligible for inclusion. Meta-analysis was performed to quantitatively summarize associations between BMI and RCD to report odds ratios and corresponding 95% confidence intervals (CIs) for regression-based models and BMI mean differences between cases and controls. Risk Of Bias In Non-randomised Studies - of Interventions tool was used to evaluate risk of bias across all studies in the systematic review.
After full-text review of 248 articles, 27 presented data on obesity and RCD, and 17 qualified for meta-analysis. Individuals with RCD were 1.21 times (95% CI 1.10-1.34) as likely to have overweight and 1.44 times (95% CI 1.32-1.59) as likely to have obesity compared with those without RCD. Each 5-unit increase in BMI was associated with 35% greater odds of having rotator cuff tear (95% CI 1.06-1.71). In-depth assessment for risk of bias shows quality of studies varies greatly and highlights outcome heterogeneity, lack of temporality, confounding and selection bias as major concerns for individual studies.
In this study, we found a positive association between elevated BMI and RCD.
Level III, systematic review and meta-analysis of Level II-III studies.
分析关于肥胖、体重指数（BMI）和肩袖疾病（RCD）的文献。
在这项系统评价和荟萃分析中，我们于2023年8月25日使用关键词查询了PubMed、Embase、Cochrane、护理及相关健康累积索引和科学直投数据库。每个比较组有超过30名参与者的分析性观察研究（队列研究、病例对照研究和横断面研究），评估肥胖与肩袖病变之间的关联，符合纳入条件。进行荟萃分析以定量总结BMI与RCD之间的关联，报告基于回归模型的比值比和相应的95%置信区间（CI）以及病例与对照之间的BMI平均差异。使用非随机干预研究中的偏倚风险工具评估系统评价中所有研究的偏倚风险。
在对248篇文章进行全文审查后，27篇文章提供了关于肥胖和RCD的数据，17篇符合荟萃分析的条件。与没有RCD的个体相比，患有RCD的个体超重的可能性高1.21倍（95%CI 1.10 - 1.34），肥胖的可能性高1.44倍（95%CI 1.32 - 1.59）。BMI每增加5个单位，肩袖撕裂的几率增加35%（95%CI 1.06 - 1.71）。对偏倚风险的深入评估表明，研究质量差异很大，并突出了结果异质性、缺乏时间顺序、混杂和选择偏倚是个别研究的主要问题。
在本研究中，我们发现BMI升高与RCD之间存在正相关。
III级，对II - III级研究的系统评价和荟萃分析。
