Involvement of Inflammatory Lipoproteinemia with Idiopathic Adhesive Capsulitis Accompanying Subclinical Hypothyroidism

• Published in: Journal of shoulder and elbow surgery 2022-10, Vol.31 (10), p.2121-2127
• Main Authors: Park, Hyung Bin, Gwark, Ji-Yong, Jung, Jaehoon, Jeong, Soon-Taek
• Format: Article
• Language: English
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2022.03.003

Thyroid functional abnormalities are considered risk factors for idiopathic adhesive capsulitis (IAC) though that relationship remains uncertain. Although dyslipidemias are associated with IAC, no readily accessible study has reported associations between dyslipidemias and IAC patients with subclinical hypothyroidism. The purposes of this study were to investigate whether subclinical hypothyroidism is an independently associated factor for IAC and to determine the differences in prevalences of dyslipidemias between two groups of persons with subclinical hypothyroidism: one composed of IAC patients, the other of individuals without IAC. This case-control study included a case group of 412 IAC patients without intrinsic shoulder lesions, extrinsic causes, or medication for thyroid dysfunction. The control group comprised 1236 age- and sex-matched persons seeking general check-ups at the authors' health promotion center during the same period as the case group. Control subjects had normal shoulder function and no previously diagnosed adhesive capsulitis, no medication for thyroid dysfunction, and no history of trauma or of shoulder surgery. The studied variables were age, gender, obesity, diabetes, dyslipidemias, subclinical hypothyroidism, hypothyroidism, and hyperthyroidism. A conditional logistic regression analysis evaluated the matched sets of subjects to determine odds ratios (ORs) and 95% confidence intervals (CIs) for the studied variables. The differences in the prevalences of dyslipidemias between IAC patients with subclinical hypothyroidism and individuals with subclinical hypothyroidism but without IAC were determined with generalized estimating equations, using covariates of age, sex, and diabetes. The P values were set at < 0.05. Subclinical hypothyroidism (OR, 2.10; 95% CI, 1.36-3.15; p = 0.001) was significantly associated with IAC. Patients with IAC and subclinical hypothyroidism had a significantly higher prevalence of hyper-LDLemia, an inflammatory lipoproteinemia, than individuals with subclinical hypothyroidism but without IAC (P =0.002). Subclinical hypothyroidism is significantly associated with IAC. Hyper-LDLemia, an inflammatory lipoproteinemia, is involved in IAC accompanied by subclinical hypothyroidism. Level III; Case-Control Design; Prognosis Study.