术前营养状况和肥胖与退行性肩袖撕裂中的肌肉萎缩和脂肪浸润相关。
Preoperative nutritional status and obesity are associated with muscle atrophy and fatty infiltration in degenerative rotator cuff tears.
作者信息
Cen Li, Tao Kun, Liu Hua, Li Ming, Zhang Yun-Feng, Huang Zhe-Yu
机构信息
Department of Joint and Sports Medicine Center, Ningbo No. 6 Hospital, Ningbo, Zhejiang,, China.
出版信息
J Orthop Surg Res. 2025 Aug 12;20(1):759. doi: 10.1186/s13018-025-06185-1.
BACKGROUND
Rotator cuff tear is a degenerative condition that has been previously linked to metabolic factors such as obesity and diabetes. However, the relationship between patients' nutritional status and rotator cuff pathology remains unclear.
METHOD
We retrospectively reviewed data from patients with degenerative rotator cuff tears who underwent arthroscopic rotator cuff repair at our institution between June and December 2024. Collected variables included demographic characteristics, imaging findings, and biochemical markers indicative of nutritional status, such as hemoglobin, total lymphocyte count, serum albumin, prealbumin, and transferrin. The prognostic nutritional index (PNI) was calculated based on lymphocyte count and serum albumin levels. Patients were stratified based on the presence or absence of muscle atrophy and fatty infiltration, and intergroup comparisons were performed. Age-adjusted logistic regression was used to identify risk factors associated with muscle atrophy and fatty infiltration.
RESULTS
A total of 109 patients met the inclusion criteria. Significant differences in age, obesity, hemoglobin, PNI, and albumin levels were observed between patients with and without muscle atrophy (all P < 0.05). Similarly, age, obesity, hemoglobin, lymphocyte count, and albumin were significantly associated with fatty infiltration (P < 0.05). After adjusting for age, obesity was associated with lower odds of muscle atrophy (OR = 4.581) and fatty infiltration (OR = 4.178). Decreased hemoglobin levels were associated with increased risk of muscle atrophy (OR = 0.954) and fatty infiltration (OR = 0.968). Lower PNI was also associated with muscle atrophy (OR = 0.822) and fatty infiltration (OR = 0.801), and reduced serum albumin levels were linked to higher odds of both outcomes (OR = 0.785 and 0.815, respectively).
CONCLUSION
Obesity and poor nutritional status may be significant risk factors for muscle atrophy and fatty infiltration in patients with rotator cuff tears.
LEVEL OF EVIDENCE
Level IV.
背景
肩袖撕裂是一种退行性疾病，此前已与肥胖和糖尿病等代谢因素相关联。然而，患者营养状况与肩袖病理之间的关系仍不清楚。
方法
我们回顾性分析了2024年6月至12月在我院接受关节镜下肩袖修复的退行性肩袖撕裂患者的数据。收集的变量包括人口统计学特征、影像学检查结果以及表明营养状况的生化指标，如血红蛋白、总淋巴细胞计数、血清白蛋白、前白蛋白和转铁蛋白。根据淋巴细胞计数和血清白蛋白水平计算预后营养指数（PNI）。根据是否存在肌肉萎缩和脂肪浸润对患者进行分层，并进行组间比较。采用年龄校正的逻辑回归分析来确定与肌肉萎缩和脂肪浸润相关的危险因素。
结果
共有109例患者符合纳入标准。有肌肉萎缩和无肌肉萎缩的患者在年龄、肥胖、血红蛋白、PNI和白蛋白水平方面存在显著差异（均P < 0.05）。同样，年龄、肥胖、血红蛋白、淋巴细胞计数和白蛋白与脂肪浸润显著相关（P < 0.05）。在调整年龄后，肥胖与肌肉萎缩（OR = 4.581）和脂肪浸润（OR = 4.178）的较低几率相关。血红蛋白水平降低与肌肉萎缩（OR = 0.954）和脂肪浸润（OR = 0.968）的风险增加相关。较低的PNI也与肌肉萎缩（OR = 0.822）和脂肪浸润（OR = 0.801）相关，血清白蛋白水平降低与这两种结果的较高几率相关（分别为OR = 0.785和0.815）。
结论
肥胖和营养状况不佳可能是肩袖撕裂患者肌肉萎缩和脂肪浸润的重要危险因素。
证据级别
四级。
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