Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 12;20(1):759.
doi: 10.1186/s13018-025-06185-1.

Preoperative nutritional status and obesity are associated with muscle atrophy and fatty infiltration in degenerative rotator cuff tears

Li Cen  1 , Kun Tao  1 , Hua Liu  1 , Ming Li  1 , Yun-Feng Zhang  1 , Zhe-Yu Huang  2
Affiliations

Preoperative nutritional status and obesity are associated with muscle atrophy and fatty infiltration in degenerative rotator cuff tears

Li Cen et al. J Orthop Surg Res. .

Abstract

Background: Rotator cuff tear is a degenerative condition that has been previously linked to metabolic factors such as obesity and diabetes. However, the relationship between patients' nutritional status and rotator cuff pathology remains unclear.

Method: We retrospectively reviewed data from patients with degenerative rotator cuff tears who underwent arthroscopic rotator cuff repair at our institution between June and December 2024. Collected variables included demographic characteristics, imaging findings, and biochemical markers indicative of nutritional status, such as hemoglobin, total lymphocyte count, serum albumin, prealbumin, and transferrin. The prognostic nutritional index (PNI) was calculated based on lymphocyte count and serum albumin levels. Patients were stratified based on the presence or absence of muscle atrophy and fatty infiltration, and intergroup comparisons were performed. Age-adjusted logistic regression was used to identify risk factors associated with muscle atrophy and fatty infiltration.

Results: A total of 109 patients met the inclusion criteria. Significant differences in age, obesity, hemoglobin, PNI, and albumin levels were observed between patients with and without muscle atrophy (all P < 0.05). Similarly, age, obesity, hemoglobin, lymphocyte count, and albumin were significantly associated with fatty infiltration (P < 0.05). After adjusting for age, obesity was associated with lower odds of muscle atrophy (OR = 4.581) and fatty infiltration (OR = 4.178). Decreased hemoglobin levels were associated with increased risk of muscle atrophy (OR = 0.954) and fatty infiltration (OR = 0.968). Lower PNI was also associated with muscle atrophy (OR = 0.822) and fatty infiltration (OR = 0.801), and reduced serum albumin levels were linked to higher odds of both outcomes (OR = 0.785 and 0.815, respectively).

Conclusion: Obesity and poor nutritional status may be significant risk factors for muscle atrophy and fatty infiltration in patients with rotator cuff tears.

Level of evidence: Level IV.

Keywords: Fatty infiltration; Muscle atrophy; Obesity; Prognostic nutritional index; Rotator cuff tears.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Patients enrollment flowchart
See this image and copyright information in PMC

References

    1. Bedi A, Bishop J, Keener J, et al. Rotator cuff tears. Nat Rev Dis Primer. 2024;10(1):1–20. 10.1038/s41572-024-00492-3. - PubMed
    1. Schiefer M, Mendonça R, Magnanini MM, et al. Intraobserver and interobserver agreement of goutallier classification applied to magnetic resonance images. J Shoulder Elb Surg. 2015;24(8):1314–21. 10.1016/j.jse.2015.02.011. - PubMed
    1. Warner JJP, Higgins L, Parsons IM, Dowdy P. Diagnosis and treatment of anterosuperior rotator cuff tears. J Shoulder Elb Surg. 2001;10(1):37–46. 10.1067/mse.2001.112022. - PubMed
    1. Liu A, Zhang B, Lai T, et al. Comparison of functional outcomes following early and delayed arthroscopic repair for traumatic and non-traumatic rotator cuff injuries. J Orthop Surg Res. 2024;19(1):368. 10.1186/s13018-024-04858-x. - PMC - PubMed
    1. Darbandi A, Credille K, Darbandi A et al. Fatty infiltration, tear size, and Retraction size are significant risk factors for retear after arthroscopic rotator cuff repair: A systematic review. Arthrosc J Arthrosc Relat Surg Published Online July 2024:S0749806324004882. 10.1016/j.arthro.2024.06.040 - PubMed