Association Between Cardiovascular Disease Risk Factors and Rotator Cuff Tendinopathy

Applegate, Kara Arnold; Thiese, Matthew S.; Merryweather, Andrew; Kapellusch, Jay; Drury, David L.; Wood, Eric M.; Kendall, Richard; Foster, James C.; Garg, Arun; Hegmann, Kurt T.

doi:10.1097/jom.0000000000000929

Cited by 41 publications

(62 citation statements)

References 57 publications

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“…Thus, strict control of diabetes with lifestyle/diet modification and careful monitoring of load progression during exercises may be indicated for the prevention and management of rotator cuff tendinopathy in diabetic patients (63). Nevertheless, other systematic disorders, such as cardiovascular disease (34) and osteoarthritis (42), were also reported to be associated with rotator cuff tendinopathy. However, the number of studies investigating these factors is small and the studies were largely heterogeneous; therefore, conducting a meta-analysis was impossible.…”

Section: Discussionmentioning

confidence: 99%

“…Two additional articles were identified through hand searching of the reference lists of the included studies. A total of 16 articles were included in this systematic review (34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49), of which 10 were eligible for meta-analysis ( Fig. 1) (34, 36-38, 41-44, 46, 49).…”

Section: Identification Of Studiesmentioning

confidence: 99%

“…The age of the participants ranged between 17 and 86 years. Of the included studies, 2 examined the general population (42,43), 13 examined the working population (34,(36)(37)(38)(39)(40)(41)(44)(45)(46)(47)(48)(49) and one evaluated elite athletes (swimmers) (35). Clinical diagnostic tests (Hawkins-Kennedy/ Neer's test/Empty can/painful arc/resisted abduction, internal rotation, external rotation or forward flexion of the shoulder) were performed in 14 studies to determine the diagnosis of rotator cuff tendinopathy, and 2 studies combined the use of clinical diagnostic test and imaging to confirm the diagnosis of rotator cuff tendinopathy (38,42).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Details of the diagnostic criteria of each study are summarized in Table III. The overall prevalence of rotator cuff tendinopathy ranged between 1.2% and 40% (general population = 1.2% (43), working population = 2.0-40% (34,36,37,(39)(40)(41)(44)(45)(46)(47)(48)(49) and elite swimmers = 1.7% (35)).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Demographics. Age above 50 years old (OR ranged between 1.03 and 4.10) (34,36,38,41,44,49); Female sex (OR = 0.33, 95% CI = 0.14-0.78) (37); and Previous shoulder injury (χ 2 = 24.9, p < 0.001) (35).…”

Section: Narrative Synthesismentioning

confidence: 99%

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Risk factors for rotator cuff tendinopathy: A systematic review and meta-analysis

Leong

et al. 2019

J Rehabil Med

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Rotator cuff tendinopathy is one of the common causes of shoulder pain. Successful treatment of rotator cuff tendinopathy remains challenging; thus, it is essential to identify risk and associated factors of rotator cuff tendinopathy in order to develop prevention interventions. The current review included 16 studies, and overall 22 factors were identified. Pooled analyses showed age above 50 years, diabetes and performing overhead activities were associated with increased risk of rotator cuff tendinopathy. Objectives: To conduct a systematic review and meta-analysis to identify risk and associated factors for symptomatic rotator cuff tendinopathy. Data sources: PubMed, CINAHL and Scopus were searched from inception to June 2017. Study selection: Participants presented with signs and symptoms suggestive of rotator cuff tendinopathy/tendinosis/tendinitis, shoulder impingement syndrome, or subacromial bursitis diagnosed by clinical tests and/or conventional imaging. Data extraction: Screening, quality assessment and data extraction were carried out by 2 reviewers. Data synthesis: Sixteen studies were included in this review. Overall, 22 factors were identified and 5 factors were explored using meta-analysis. Pooled analyses provided strong evidence that age above 50 years (odds ratio (OR) = 3.31, 95% confidence interval (95% CI) = 2.30-4.76, I 2 = 0%, p < 0.001) and diabetes (OR = 2.24, 95% CI = 1.37-3.65, I 2 = 0%, p = 0.001) were associated with increased risk of rotator cuff tendinopathy. In addition, moderate evidence showed that work with the shoulder above 90° was associated with increased risk of rotator cuff tendinopathy (OR = 2.41, 95% CI = 1.31-4.45, I 2 = 83%, p = 0.005). Conclusion: Age above 50 years, diabetes and overhead activities were associated with increased risk of rotator cuff tendinopathy.

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Section: Discussionmentioning

confidence: 99%

Section: Identification Of Studiesmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Narrative Synthesismentioning

confidence: 99%

See 3 more Smart Citations

Risk factors for rotator cuff tendinopathy: A systematic review and meta-analysis

Leong

et al. 2019

J Rehabil Med

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Patellar tendon biomechanical and morphologic properties and their relationship to serum clinical variables in persons with prediabetes and type 2 diabetes

Patel,

Campbell,

Emenim

et al. 2024

Journal Orthopaedic Research

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Tendon biomechanical properties and fibril organization are altered in patients with diabetes compared to healthy individuals, yet few biomarkers have been associated with in vivo tendon properties. We investigated the relationships between in vivo imaging‐based tendon properties, serum variables, and patient characteristics across healthy controls (n = 14, age: 45 ± 5 years, body mass index [BMI]: 24 ± 1, hemoglobin A1c [HbA1c]: 5.3 ± 0.1%), prediabetes (n = 14, age: 54 ± 5 years, BMI: 29 ± 2; HbA1c: 5.7 ± 0.1), and type 2 diabetes (n = 13, age: 55 ± 3 years, BMI: 33 ± 2, HbA1c: 6.7 ± 0.3). We used ultrasound speckle‐tracking and measurements from magnetic resonance imaging (MRI) to estimate the patellar tendon in vivo tangent modulus. Analysis of plasma c‐peptide, interleukin‐1β (IL‐1β), IL‐6, IL‐8, tumor necrosis factor‐α (TNF‐α), adiponectin, leptin, insulin‐like growth factor 1 (IGF‐1), and C‐reactive protein (CRP) was completed. We built regression models incorporating statistically significant covariates and indicators for the clinically defined groups. We found that tendon cross‐sectional area normalized to body weight (BWN CSA) and modulus were lower in patients with type 2 diabetes than in healthy controls (p < 0.05). Our regression analysis revealed that a model that included BMI, leptin, high‐density lipoprotein (HDL), low‐density lipoprotein (LDL), age, and group explained ~70% of the variability in BWN CSA (R2 = 0.70, p < 0.001). For modulus, including the main effects LDL, groups, HbA1c, age, BMI, cholesterol, IGF‐1, c‐peptide, leptin, and IL‐6, accounted for ~54% of the variability in modulus (R2 = 0.54, p < 0.05). While BWN CSA and modulus were lower in those with diabetes, group was a poor predicter of tendon properties when considering the selected covariates. These data highlight the multifactorial nature of tendon changes with diabetes and suggest that blood variables could be reliable predictors of tendon properties.

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Genetics in Rotator Cuff Tears: First Steps to the Future

Cohen

Figueiredo

Leal

et al. 2019

Rotator Cuff Across the Life Span

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Association Between Cardiovascular Disease Risk Factors and Rotator Cuff Tendinopathy

Abstract: Individual risk factors were associated with both outcomes. Combined, CVD risk factors demonstrated a strong correlation with glenohumeral joint pain and an even stronger correlation with rotator cuff tendinopathy. Results suggest a potentially modifiable disease mechanism.

Cited by 41 publications

References 57 publications

Risk factors for rotator cuff tendinopathy: A systematic review and meta-analysis

Risk factors for rotator cuff tendinopathy: A systematic review and meta-analysis

Patellar tendon biomechanical and morphologic properties and their relationship to serum clinical variables in persons with prediabetes and type 2 diabetes

Genetics in Rotator Cuff Tears: First Steps to the Future

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