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

• Published in: BMC musculoskeletal disorders 2023-12, Vol.24 (1), p.1-10
• Main Authors: Park, Hyung Bin, Gwark, Ji-Yong, Jung, Jaehoon
• Format: Article
• Language: English
• Subjects: Blood pressure; Blood sugar; Complications and side effects; Degeneration (Pathology); Diabetes; Disease; Fasting; Fasting glucose level; Glucose; Health aspects; Health care expenditures; High density lipoprotein; Hypertension; Insulin resistance; Laboratory testing; Lipids; Lipoproteins; Measurement; Metabolic syndrome; Normoglycemia; Population studies; Regression analysis; Risk factors; Rotator cuff; Rotator cuff (Anatomy); Rotator cuff tendon tear; Shoulder; Shoulder injuries; Tendon injuries; TG/HDL ≥ 3.5; Variables; Womens health
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-023-06899-5

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) [greater than or equal to] 3.5. Logistic regression analysis was used to determine the association between fasting glucose level, TG/HDL [greater than or equal to] 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 [greater than or equal to] 3.5 were significantly associated with degenerative RCT. Fasting glucose levels [greater than or equal to] 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 [greater than or equal to] 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: Rotator cuff tendon tear, Risk factors, Normoglycemia, Fasting glucose level, TG/HDL [greater than or equal to] 3.5, Insulin resi