Is Adiposity an Under-Recognized Risk Factor for Tendinopathy? A Systematic Review
Is Adiposity an Under-Recognized Risk Factor for Tendinopathy? A Systematic Review
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DOI：
10.1002/art.24518
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发表时间：
2009-06-15
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影响因子：
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通讯作者：
Cook, Jill L.
中科院分区：
文献类型：
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作者：
Gaida, James E.;Ashe, Maureen C.;Cook, Jill L.
Objective.据报道，肌腱损伤在肥胖增加的个体中更常见。在这些人中，治疗似乎也有较差的结果。我们的目的是检查肥胖和肌腱病之间的关联的程度和一致性。对观察性研究进行了系统综述。检索了8个电子数据库（Allied and Complementary Medicine、Biological Abstracts、CINAHL、Current Contents、EMBase、Medline、SPORTDiscus和Web of Science），并对纳入的报告进行了引文跟踪。如果研究比较了有和没有肌腱损伤的受试者之间的肥胖情况，或者研究了肥胖作为保守治疗成功的预测因素，则纳入研究。4个纵向队列、14项横断面研究、8项病例对照研究和2项干预性研究（共28项）符合纳入标准，共提供19，949例受试者。确定了42个亚群，其中18个表现出与肌腱损伤相关的肥胖升高（43%）。敏感性分析表明，在包括临床患者的研究（81%阳性）和病例对照研究（77%阳性）中，阳性结果聚集。脂肪过多常与肌腱损伤有关。已发表的报告表明，肥胖是肌腱损伤的一个危险因素，尽管这种关联似乎因研究设计和测量方面而异。脂肪在肌腱研究中特别感兴趣，因为与许多其他报告的肌腱损伤风险因素不同，它在某种程度上是可以预防和改变的。需要进一步的研究来确定减少肥胖是否会降低肌腱损伤的风险或改善治疗结果。
Objective. Tendon injuries have been reported to occur more frequently in individuals with increased adiposity. Treatment also appears to have poorer outcomes among these individuals. Our objective was to examine the extent and consistency of associations between adiposity and tendinopathy.Methods. A systematic review of observational studies was conducted. Eight electronic databases were searched (Allied and Complementary Medicine, Biological Abstracts, CINAHL, Current Contents, EMBase, Medline, SPORTDiscus, and Web of Science) and citation tracking was performed on included reports. Studies were included if they compared adiposity between subjects with and without tendon injury or examined adiposity as a predictor of conservative treatment success.Results. Four longitudinal cohorts, 14 cross-sectional studies, 8 case-control studies, and 2 interventional studies (28 in total) met the inclusion criteria, providing a total of 19,949 individuals. Forty-two subpopulations were identified, 18 of which showed elevated adiposity to be associated with tendon injury (43%). Sensitivity analyses indicated a clustering of positive findings among studies that included clinical patients (81% positive) and among case-control studies (77% positive).Conclusion. Elevated adiposity is frequently associated with tendon injury. Published reports suggest that elevated adiposity is a risk factor for tendon injury, although this association appears to vary depending on aspects of study design and measurement. Adiposity is of particular interest in tendon research because, unlike a number of other reported risk factors for tendon injury, it is somewhat preventable and modifiable. Further research is required to determine if reducing adiposity will reduce the risk of tendon injury or improve the results of treatment.