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. 2023 Dec 16;24(1):973.
doi: 10.1186/s12891-023-06899-5.

Associations of normal fasting glucose levels and of insulin resistance with degenerative rotator cuff tear : Normoglycemia and rotator cuff tear

Hyung Bin Park  1   2 , Ji-Yong Gwark  3   4 , Jaehoon Jung  5
Affiliations

Associations of normal fasting glucose levels and of insulin resistance with degenerative rotator cuff tear : Normoglycemia and rotator cuff tear

Hyung Bin Park et al. BMC Musculoskelet Disord. .

Abstract

Background: The upper normoglycemic range has been proposed as a risk factor for degenerative rotator cuff tendon tear (RCT), and insulin resistance has been suggested as a risk factor for tendinopathy. However, no research has established their association with degenerative RCT in the general population. This study aimed to determine whether fasting glucose levels and insulin resistance are risk factors for degenerative RCT in the normoglycemic population and identify the risk range for fasting glucose.

Methods: This study included 418 normoglycemic participants from a rural cohort. Participants completed questionnaires, physical exams, blood tests, and MRI evaluations of both shoulders. Insulin resistance was assessed using a triglyceride/high-density-lipoprotein (TG/HDL) ≥ 3.5. Logistic regression analysis was used to determine the association between fasting glucose level, TG/HDL ≥ 3.5, and other factors and degenerative RCT. The study calculated the areas under the receiver operating characteristic curve (AUC) to determine the more appropriate predicting value between the scale and categorical values of fasting glucose levels, and compared the AUCs using the DeLong method.

Results: In the multivariable analyses, both scale and categorical values of fasting glucose levels, and TG/HDL ≥ 3.5 were significantly associated with degenerative RCT. Fasting glucose levels ≥ 90.5 mg/dL (OR: 3.87, 95% CI: 2.10-7.06) in scale value and 90-99 mg/dL (OR: 4.13, 95% CI: 2.87-8.12) in categorical value were significantly associated with degenerative RCT (P < .001). The AUC of the scale value of fasting glucose levels ≥ 90.5 mg/dL was 0.68. The AUC of the categorical value of fasting glucose levels of 90-99 mg/dL was 0.70. Because of the significantly larger AUC of the categorical value of fasting glucose levels of 90-99 mg/dL, those fasting glucose levels were determined to be independently associated with degenerative RCT (P < .001).

Conclusions: High fasting glucose levels within the normal range may link to increase insulin resistance and risk of degenerative RCT. Normoglycemic levels of 90-99 mg/dL and insulin resistance may be risk factors for degenerative RCT.

Level of evidence: Level III, prognostic study.

Keywords: Fasting glucose level; Insulin resistance; Normoglycemia; Risk factors; Rotator cuff tendon tear; TG/HDL ≥ 3.5.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart for exclusion and inclusion criteria for this study. All 418 subjects met our inclusion and exclusion criteria
Fig. 2
Fig. 2
The forest plot shows the odd ratios for each quartile of fasting glucose levels and rotator cuff tear
Fig. 3
Fig. 3
Receiver operating curve analysis for the cut-off value of fasting glucose level. Area under curve was 0.68 (95% CI 0.62 to 0.75; p < .001). Cut-off value was 90.5 mg/dL (sensitivity 72%, specificity 65%, positive predictive value 29%, and negative predictive value 92%)
Fig. 4
Fig. 4
Receiver operating curve analysis for the categorical value of fasting glucose level (90–99 mg/dL). Area under curve was 0.70 (95% CI [0.63–0.76]; p < .001). The sensitivity, specificity, positive predictive value, and negative predictive value were 79%, 60%, 29%, and 93%, respectively
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References

    1. Ensor KL, Kwon YW, Dibeneditto MR, Zuckerman JD, Rokito AS. The rising incidence of rotator cuff repairs. J Shoulder Elbow Surg. 2013;22(12):1628–32. doi: 10.1016/j.jse.2013.01.006. - DOI - PubMed
    1. Longo UG, Salvatore G, Rizzello G, Berton A, Ciuffreda M, Candela V, Denaro V. The burden of rotator cuff surgery in Italy: a nationwide registry study. Arch Orthop Trauma Surg. 2017;137(2):217–24. doi: 10.1007/s00402-016-2610-x. - DOI - PubMed
    1. Longo UG, Franceschi F, Ruzzini L, Rabitti C, Morini S, Maffulli N, Denaro V. Histopathology of the supraspinatus tendon in rotator cuff tears. Am J Sports Med. 2008;36(3):533–8. doi: 10.1177/0363546507308549. - DOI - PubMed
    1. Longo UG, Franceschi F, Ruzzini L, Rabitti C, Morini S, Maffulli N, Denaro V. Characteristics at haematoxylin and eosin staining of ruptures of the long head of the biceps tendon. Br J Sports Med. 2009;43(8):603–7. doi: 10.1136/bjsm.2007.039016. - DOI - PubMed
    1. Longo UG, Franceschi F, Ruzzini L, Rabitti C, Morini S, Maffulli N, Forriol F, Denaro V. Light microscopic histology of supraspinatus tendon ruptures. Knee Surg Sports Traumatol Arthrosc. 2007;15(11):1390–4. doi: 10.1007/s00167-007-0395-8. - DOI - PubMed