Does Leptin and Insulin Levels Influence Pain and Disability in Subjects With Frozen Shoulder? A Cross-Sectional Study

IF 3.5 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-03-11 DOI:10.1002/ejp.70007

José Javier Pérez-Montilla, Rafael Guzmán-García, Leo Pruimboom, Santiago Navarro-Ledesma

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Abstract

Objective

To investigate the relationship between leptin levels, insulin resistance (measured by HOMA), and clinical outcomes related to pain, disability, and shoulder range of motion (ROM) in patients with frozen shoulder (FS).

Methods

This cross-sectional study included 34 patients diagnosed with FS. Leptin and HOMA levels were measured and analysed in relation to pain and disability scores, as assessed by the Shoulder Pain and Disability Index (SPADI), along with shoulder ROM (flexion, extension, abduction, adduction, and internal/external rotation). Linear regression models were used to evaluate associations between leptin, HOMA, and clinical outcomes, adjusting for potential confounders such as age and sex.

Results

Higher leptin levels were significantly associated with increased SPADI pain (R² = 0.114, β = 0.397, p = 0.005) and disability scores (R² = 0.110, β = 0.425, p = 0.006), as well as an inverse association with shoulder flexion (R² = 0.074, β = −1.088, p = 0.025), indicating reduced ROM with higher leptin levels. Similarly, higher HOMA levels were associated with increased SPADI pain (R² = 0.096, β = 1.078, p = 0.010) and disability scores (R² = 0.081, β = 1.517, p = 0.017), as well as combined SPADI scores (R² = 0.089, β = 2.595, p = 0.014). HOMA also showed a significant inverse relationship with shoulder flexion (R² = 0.061, β = −2.097, p = 0.028), suggesting that insulin resistance may contribute to ROM limitations.

Conclusion

Elevated leptin and insulin resistance levels were linked to greater pain, disability, and decreased ROM in patients with FS. These findings underscore the potential role of metabolic and inflammatory pathways in FS pathogenesis and highlight the importance of considering lifestyle interventions targeting leptin and insulin regulation as adjuncts to traditional management strategies for this condition.

Significance Statement

Elevated levels of leptin and HOMA (insulin resistance) are significantly associated with increased pain and disability in patients with frozen shoulder, as measured by SPADI scores. Higher leptin and HOMA levels are also associated with reduced range of motion, particularly in shoulder flexion. Targeting metabolic and inflammatory markers such as leptin and insulin resistance could inform new therapeutic approaches for managing frozen shoulder, with potential implications for treatment strategies in other inflammatory musculoskeletal conditions.

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瘦素和胰岛素水平是否影响肩周炎患者的疼痛和残疾？横断面研究

目的探讨冻疮（FS）患者瘦素水平、胰岛素抵抗（HOMA测量）与疼痛、残疾和肩关节活动度（ROM）相关的临床结局之间的关系。方法对34例确诊为FS的患者进行横断面研究。通过肩部疼痛和残疾指数（SPADI）以及肩部ROM（屈曲、伸展、外展、内收和内/外旋）评估，测量和分析瘦素和HOMA水平与疼痛和残疾评分的关系。线性回归模型用于评估瘦素、HOMA和临床结果之间的关系，并对年龄和性别等潜在混杂因素进行调整。结果高瘦素水平与SPADI疼痛增加（R2 = 0.114, β = 0.397, p = 0.005）和残疾评分增加（R2 = 0.110, β = 0.425, p = 0.006）显著相关，与肩关节屈曲呈负相关（R2 = 0.074, β = - 1.088, p = 0.025），表明高瘦素水平降低了ROM。同样，较高的HOMA水平与SPADI疼痛（R2 = 0.096, β = 1.078, p = 0.010）和残疾评分（R2 = 0.081, β = 1.517, p = 0.017）以及SPADI综合评分（R2 = 0.089, β = 2.595, p = 0.014）增加相关。HOMA也与肩关节屈曲呈显著负相关（R2 = 0.061, β = - 2.097, p = 0.028），提示胰岛素抵抗可能导致ROM限制。结论瘦素和胰岛素抵抗水平升高与FS患者更大的疼痛、残疾和活动度下降有关。这些发现强调了代谢和炎症途径在FS发病机制中的潜在作用，并强调了考虑以瘦素和胰岛素调节为目标的生活方式干预作为该疾病传统管理策略辅助手段的重要性。SPADI评分显示，瘦素和HOMA（胰岛素抵抗）水平升高与肩关节冻结患者疼痛和残疾增加显著相关。高瘦素和HOMA水平也与活动范围缩小有关，尤其是肩关节屈曲。针对代谢和炎症标志物，如瘦素和胰岛素抵抗，可以为治疗肩周炎提供新的治疗方法，对其他炎症性肌肉骨骼疾病的治疗策略也有潜在的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.