Download PDF
CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(02): 282-288
DOI: 10.1055/s-0041-1729937
Artigo Original
Ombro e Cotovelo

Rotator Cuff Lesion and Obesity: A Demographic and Metabolic Evaluation[*]

Article in several languages: português | English
Saulo Teixeira Pansiere 
1   Instituto de Pesquisa e Ensino do Hospital Ortopédico e Medicina Especializada (IPE-HOME), Brasília, DF, Brasil
2   Centro de Traumato-ortopedia do Esporte (Cete), Universidade Federal de São Paulo (Unifesp), São Paulo, Brasil
,
Arlane Carvalho de Oliveira 
1   Instituto de Pesquisa e Ensino do Hospital Ortopédico e Medicina Especializada (IPE-HOME), Brasília, DF, Brasil
,
Alberto de Castro Pochini 
2   Centro de Traumato-ortopedia do Esporte (Cete), Universidade Federal de São Paulo (Unifesp), São Paulo, Brasil
,
Benno Ejnisman 
2   Centro de Traumato-ortopedia do Esporte (Cete), Universidade Federal de São Paulo (Unifesp), São Paulo, Brasil
,
Paulo Santoro Belangero 
2   Centro de Traumato-ortopedia do Esporte (Cete), Universidade Federal de São Paulo (Unifesp), São Paulo, Brasil
,
Carlos Vicente Andreoli 
2   Centro de Traumato-ortopedia do Esporte (Cete), Universidade Federal de São Paulo (Unifesp), São Paulo, Brasil
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Objective To analyze the relationship between the presence and severity of rotator cuff (RC) injury with obesity and the time of exposure to obesity. Secondarily, to evaluate the relationship and prevalence of demographic and metabolic factors in obese individuals with RC injury.

Methods This is a cross-sectional study with 235 obese patients (body mass index [BMI] ≥ 30 kg/m2). Demographic data (age and gender), metabolic data (hypertension, diabetes mellitus, lipid profile, and time of exposure to obesity), physical examination (weight, height, waist circumference, and clinical tests), and musculoskeletal ultrasound examination were used to analyze the results.

Results There was no evidence of an association between RC injury and BMI (p = 0.82), time of exposure to obesity (p = 0.29), or abdominal circumference (p = 0.52). In the subgroup with injury, age (p < 0.001), presence of diabetes mellitus (p = 0.013), hypertension (p < 0.001), level of high-density lipoprotein (HDL) (p = 0.026), and time of exposure to obesity (p < 0.001) were significantly greater compared to the subgroup without injury. In the search for other parameters independently associated with RC injury, associations were observed with age (p = 0.0003) and hypertension (p = 0.004).

Conclusion We did not evidence an association between obesity and the time of exposure to it with the occurrence and severity of RC injury. However, individuals with injury had a longer time of exposure to obesity and prevalence of metabolic disorders than individuals without RC injury. In addition, our findings suggest an association between systemic arterial hypertension (SAH) and advanced age with RC injury.

Keywords

rotator cuff - obesity - body mass index - diabetes - arterial hypertension - ultrasonography

Financial Support

There was no financial support from public, commercial, or non-profit sources.


Study developed at Centro de Traumato-ortopedia do Esporte (CETE), Universidade Federal de São Paulo (UNIFESP), São Paulo. Brazil.




Publication History

Received: 09 May 2020

Accepted: 01 December 2020

Article published online:
27 January 2022

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Referências

  • 1 Aronow WS. Association of obesity with hypertension. Ann Transl Med 2017; 5 (17) 350
    CrossrefPubMedGoogle Scholar
  • 2 Al-Goblan AS, Al-Alfi MA, Khan MZ. Mechanism linking diabetes mellitus and obesity. Diabetes Metab Syndr Obes 2014; 7: 587-591
    Google Scholar
  • 3 Loures FB, de Araújo Góes RF, Labronici PJ, Barretto JM, Olej B. Evaluation of body mass index as a prognostic factor in osteoarthrosis of the knee. Rev Bras Ortop 2016; 51 (04) 400-404
    Google Scholar
  • 4 Afshin A, Forouzanfar MH, Reitsma MB. et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med 2017; 377 (01) 13-27
    CrossrefPubMedGoogle Scholar
  • 5 Brasil. Ministério da Saúde. Vigitel Brazil 2018: surveillance of risk and protective factors for chronic diseases by telephone survey: estimates of frequency and sociodemographic distribution of risk and protective factors for chronic diseases in the capitals of the 26 Brazilian states and the Federal District in 2018. Brasilia: Editora MS; 2018
    Google Scholar
  • 6 Melin EO, Thulesius HO, Hillman M, Landin-Olsson M, Thunander M. Abdominal obesity in type 1 diabetes associated with gender, cardiovascular risk factors and complications, and difficulties achieving treatment targets: a cross sectional study at a secondary care diabetes clinic. BMC Obes 2018;15(05):
    Google Scholar
  • 7 Patel SA, Ali MK, Alam D. et al. Obesity and its Relation With Diabetes and Hypertension: A Cross-Sectional Study Across 4 Geographical Regions. Glob Heart 2016; 11 (01) 71-79.e4
    CrossrefPubMedGoogle Scholar
  • 8 Engin A. The Definition and Prevalence of Obesity and Metabolic Syndrome. Adv Exp Med Biol 2017; 960: 1-17
    CrossrefPubMedGoogle Scholar
  • 9 Gumina S, Candela V, Passaretti D. et al. The association between body fat and rotator cuff tear: the influence on rotator cuff tear sizes. J Shoulder Elbow Surg 2014; 23 (11) 1669-1674
    CrossrefPubMedGoogle Scholar
  • 10 Walsh TP, Arnold JB, Evans AM, Yaxley A, Damarell RA, Shanahan EM. The association between body fat and musculoskeletal pain: a systematic review and meta-analysis. BMC Musculoskelet Disord 2018;233(19):
    Google Scholar
  • 11 Franceschi F, Papalia R, Paciotti M. et al. Obesity as a risk factor for tendinopathy: a systematic review. Int J Endocrinol 2014; 2014: 1-10
    CrossrefPubMedGoogle Scholar
  • 12 Corbin LJ, Richmond RC, Wade KH. et al. Body mass index as a modifiable risk factor for type 2 diabetes: Refining and understanding causal estimates using Mendelian randomisation. Diabetes 2016; 65 (10) 3002-3007
    CrossrefPubMedGoogle Scholar
  • 13 Özkuk K, Ateş Z. The effect of obesity on pain and disability in chronic shoulder pain patients. J Back Musculoskeletal Rehabil 2020; 33 (01) 73-79
    CrossrefPubMedGoogle Scholar
  • 14 Scott A, Zwerver J, Grewal N. et al. Lipids, adiposity and tendinopathy: is there a mechanistic link? Critical review. Br J Sports Med 2015; 49 (15) 984-988
    CrossrefPubMedGoogle Scholar
  • 15 Burne G, Mansfield M, Gaida JE, Lewis JS. Is there an association between metabolic syndrome and rotator cuff-related shoulder pain? A systematic review. BMJ Open Sport Exerc Med 2019; 5 (01) e000544
    CrossrefPubMedGoogle Scholar
  • 16 Sayampanathan AA, Andrew THC. Systematic review on risk factors of rotator cuff tears. J Orthop Surg (Hong Kong) 2017;25(01):
    Google Scholar
  • 17 Ahmed AS. Does Diabetes Mellitus Affect Tendon Healing?. Adv Exp Med Biol 2016; 920: 179-184
    CrossrefPubMedGoogle Scholar
  • 18 Lui PPY. Tendinopathy in diabetes mellitus patients-Epidemiology, pathogenesis, and management. Scand J Med Sci Sports 2017; 27 (08) 776-787
    CrossrefPubMedGoogle Scholar
  • 19 Gumina S, Arceri V, Carbone S. et al. The association between arterial hypertension and rotator cuff tear: the influence on rotator cuff tear sizes. J Shoulder Elbow Surg 2013; 22 (02) 229-232
    CrossrefPubMedGoogle Scholar
  • 20 Djerbi I, Chammas M, Mirous MP, Lazerges C, Coulet B. French Society For Shoulder and Elbow (SOFEC). Impact of cardiovascular risk factor on the prevalence and severity of symptomatic full-thickness rotator cuff tears. Orthop Traumatol Surg Res 2015; 101 (6Suppl) S269-S273
    CrossrefPubMedGoogle Scholar
  • 21 Lewis J. Rotator cuff related shoulder pain: Assessment, management and uncertainties. Man Ther 2016; 23: 57-68
    CrossrefPubMedGoogle Scholar
  • 22 Titchener AG, White JJ, Hinchliffe SR, Tambe AA, Hubbard RB, Clark DI. Comorbidities in rotator cuff disease: a case-control study. J Shoulder Elbow Surg 2014; 23 (09) 1282-1288
    CrossrefPubMedGoogle Scholar
  • 23 Cochran WG. Sampling Techniques. 3rd ed.. New Jersey: Wiley; 1977
    Google Scholar
  • 24 Jobe FW, Jobe CM. Painful athletic injuries of the shoulder. Clin Orthop Relat Res 1983; (173) 117-124
    PubMedGoogle Scholar
  • 25 Holtby R, Razmjou H. Validity of the supraspinatus test as a single clinical test in diagnosing patients with rotator cuff pathology. J Orthop Sports Phys Ther 2004; 34 (04) 194-200
    CrossrefPubMedGoogle Scholar
  • 26 Jain NB, Wilcox III RB, Katz JN, Higgins LD. Clinical examination of the rotator cuff. PM R 2013; 5 (01) 45-56
    CrossrefPubMedGoogle Scholar
  • 27 Selvaraj SS, Kiran Das S, Murthy N, Patil V, Hiremath R. Diagnostic accuracy of ultrasound vs. MRI in evaluation of rotator cuff injuries. Int J Radiol Diag Imag 2019; 2 (02) 92-95
    CrossrefGoogle Scholar
  • 28 El-Kouba G, Andreas Huber T, Freitas JR, Steglich V, Ayzemberg H, Santos AM. Comparison of complementary exams in the diagnosis of rotator cuff injuries. Rev Bras Ortop 2015; 45 (05) 418-425
    Google Scholar
  • 29 Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA. The demographic and morphological features of rotator cuff disease. A comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg Am 2006; 88 (08) 1699-1704
    CrossrefPubMedGoogle Scholar
  • 30 Abate M, Schiavone C, Salini V. Sonographic evaluation of the shoulder in asymptomatic elderly subjects with diabetes. BMC Musculoskelet Disord 2020;278(11):
    Google Scholar