代谢紊乱和肌腱病变之间的相互作用：系统回顾和荟萃分析

IF 2.7 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-09-10 DOI:10.1002/jeo2.70429

Paola De Luca, Giulio Grieco, Silvia Bargeri, Cecilia Colombo, Stefania Guida, Michela M. Taiana, Laura de Girolamo

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引用次数: 0

摘要

目的评估肌腱病变的患病率与代谢因素的关系，并探讨肌腱病变与代谢状况之间的关系。方法本综述根据系统评价和元分析指南的首选报告项目和预先设计的标准综合筛选了PubMed、Scopus和Web of Science截至2024年3月31日发表的文章。符合条件的研究包括队列、病例对照或横断面设计。结果共纳入53项研究。跟腱病变在糖尿病患者中非常普遍（6%；95%可信区间[CI]: 42%-91%）。此外，糖尿病被确定为跟腱病变发展的危险因素，优势比（OR）为7.22 （95% CI: 2.61-19.97）。糖尿病也与上肢肌腱病变有关，包括内侧上髁炎（OR: 11.27, 95% CI: 2.01-63.02）和扳机指（OR: 3.79, 95% CI: 1.87-7.65）。综合患病率估计发现，13% （95% CI: 4%-21%）的腱鞘病患者患有高胆固醇血症，38% （95% CI: 5%-80%）的腱鞘病在他汀类药物使用者中发现。然而，研究的高度异质性限制了这两个结果的可靠性。即使在总患病率为64% （95% CI: 62%-66%）的肌腱病变患者中观察到体重指数改变，也不能明确确定病因。对性别影响的分析显示，男性患与血脂异常相关的肌腱病变的比例更高，而糖尿病女性患触发指肌腱病变的比例更高。结论糖尿病、血脂异常和肥胖是肌腱病变发生的重要因素，其病因多因素，性别差异影响具体病理。这些发现建议对肌腱负荷过重、慢性疼痛或复发性损伤的易感个体进行定期代谢评估。证据等级三级。

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The interplay between metabolic disorders and tendinopathies: Systematic review and meta-analysis

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The interplay between metabolic disorders and tendinopathies: Systematic review and meta-analysis

Purpose

To evaluate the prevalence of tendinopathies in relation to metabolic factors and to investigate associations between tendinopathies and metabolic conditions.

Methods

The current review synthesised screened articles in accordance with the preferred reporting items for systematic reviews and meta-analyses guidelines predesigned criterion which were from PubMed, Scopus and Web of Science published up to 31 March 2024. Eligible studies included cohort, case-control or cross-sectional designs.

Results

Fifty-three studies were included. Achilles tendinopathy emerged as highly prevalent in diabetic individuals (6%; 95% confidence interval [CI]: 42%–91%). Moreover, diabetes was identified as a risk factor for Achilles tendinopathy development with an odds ratio (OR) of 7.22 (95% CI: 2.61–19.97). Diabetes was also linked to upper limb tendinopathies, including medial epicondylitis (OR: 11.27, 95% CI: 2.01–63.02) and trigger finger (OR: 3.79, 95% CI: 1.87–7.65). A pooled prevalence estimate found that 13% (95% CI: 4%–21%) of tendinopathy patients had hypercholesterolaemia and a prevalence of 38% (95% CI: 5%–80%) of tendinopathy was found among statin users. However, high study heterogeneity limited the reliability of these two findings. Even if body mass index alterations were observed in tendinopathy patients with a pooled prevalence of 64% (95% CI: 62%–66%), a causation could not be definitively established. The analysis of the impact of sex exhibited men higher rates of tendon pathology associated with dyslipidaemia, whereas diabetic women demonstrated a greater prevalence of trigger finger tendinopathy.

Conclusion

Results showed that diabetes, dyslipidaemia and obesity contribute to the tendinopathies development, highlighting their multifactorial aetiology with sex differences influencing specific pathologies. These findings suggested periodic metabolic evaluations in susceptible individuals to tendon overload, chronic pain or recurrent injuries.