The effect of lipid levels on patient-reported outcomes in patients with rotator cuff tears

Abstract

BackgroundLipid disorders could be associated with the prevalence and outcomes of rotator cuff diseases. This study aimed to learn how levels of various types of lipids influence the patient-reported outcomes of patients with rotator cuff tears (RCTs).MethodsData from a cohort study of 135 patients with RCTs were used. The outcome measures included Western Ontario Rotator Cuff (WORC) index, American Shoulder and Elbow Surgeons (ASES) standardized shoulder assessment form, Single Assessment Numeric Evaluation, visual analog scale for pain and satisfaction, and Veterans RAND 12-Item Health Survey (VR-12). Multivariable random-effects models were built to examine how total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein, and ratio of total cholesterol to HDL influence each outcome, controlling for covariates.ResultsAfter adjusting for age, gender, surgery, smoking, and baseline outcome values, patients with triglycerides >150 mg/dL had significantly higher pain visual analog scale (β = 5.86; P = .017) and lower VR-12 physical component summary (β = −2.71; P = .002) scores. Patients with low HDL had significantly worse WORC (β = 132.26; P = .020) and ASES (β = −7.05; P = .005) scores, more pain (β = 6.69; P = .024), and less satisfaction (β = −6.53; P = .008). The ratio of total cholesterol to HDL was associated with worse WORC (β = 58.46; P = .006) and ASES scores (β = −2.74; P = .002), more pain (β = 4.49; P < .001), and worse VR-12 physical component summary score (β = −1.03; P = .017).ConclusionsDyslipidemia may decrease the improvement of patient-reported outcomes in patients undergoing treatment for RCTs; high triglycerides and low HDL may have the most impact.

Is there an association between metabolic syndrome and rotator cuff-related shoulder pain? A systematic review

“…Diabetes is associated with an upregulation of proinflammatory cytokines as the anti-inflammatory actions of insulin is impaired, inducing deregulation of the tendon matrix, which may lead to symptoms and functional impairments of the affected tendon 55. The role of dyslipidaemia association is inconsistent with two cohort studies and one cross-sectional study reporting elevated triglyceride and low HDL-C, impact pain and outcome in rotator cuff tears as compared with control groups 47 56 57. Conversely, Longo et al 58 conducted a case–control study finding no significant difference between total cholesterol and triglyceride concentrations in people with rotator cuff tears and asymptomatic controls.…”

The effects of hyperlipidemia on rotator cuff diseases: a systematic review

“…Six studies were conducted in European countries [ 12 , 19 , 20 , 22 , 23 , 28 ], six in North American countries [ 17 , 21 , 25 , 26 , 29 , 30 ], and four in Asian countries [ 8 , 24 , 27 , 31 ]. Three studies were prospective cohort study [ 21 , 23 , 25 ], seven were retrospective cohort study [ 8 , 17 , 20 , 24 , 26 , 27 , 29 ], two were case-control study [ 12 , 31 ], two were cross-sectional study [ 19 , 30 ], one was case series [ 28 ], and one was retrospective observational study [ 22 ]. Of the 16 studies analyzed, ten were comparative and analyzed using the 24-point scale; the remaining six non-comparative studies were analyzed on the 16-point scale.…”

“…The participants included varied among all eligible studies. Twelve studies only included subjects without rotator cuff surgical repair [ 8 , 12 , 19 – 25 , 28 , 30 , 31 ], three studies only included patients with rotator cuff surgical repair [ 17 , 26 , 27 ], and one study included patients with surgical treatment or conservative treatment [ 29 ]. The total sample size ranged from 85 to 498,678.…”

“…Three studies did not specify the definition of dyslipidemia and the kinds of lipids [ 8 , 22 , 31 ]. Nine studies determined the dyslipidemia only by the levels of lipids [ 12 , 17 , 19 , 21 , 24 , 25 , 27 , 29 , 30 ]. Three studies diagnosed the dyslipidemia based on medical history, cholesterol-lowering drugs, and the levels of lipids [ 20 , 23 , 28 ].…”

“…The kinds of lipids were not defined Records of statin prescriptions were recorded and analyzed There was no association of bilateral rotator cuff tears with hypercholesterolemia and statin therapy No Applegate et al [ 30 ] TC ≥ 200 mg/dL Not specified Hypercholesterolemia was statistically associated with glenohumeral joint pain, but not rotator cuff tendinopathy. No Lai et al [ 29 ] TC ≥ 200 mg/dL, TG ≥ 150 mg/dL, LDL-C ≥ 130 mg/dL, HDL-C < 40 mg/dL Not specified Dyslipidemia might decrease the improvement of patient-reported outcomes in patients undergoing treatment for rotator cuff tears. High triglycerides and low HDL might have the most impact.…”