Abstract
Backgrounds: Recently, the association between sarcopenia and various musculoskeletal disorders, such as lumbar spine stenosis and fibromyalgia, has been highlighted. However, the relationship between sarcopenia and rotator cuff tendon diseases has rarely been investigated. This study aimed to evaluate whether sarcopenia was associated with shoulder pain and to determine whether rotator cuff tendons differed in echotexture between the sarcopenic and non-sarcopenic populations.Methods: The thickness and echogenicity ratio of the tendon vs. the overlying muscle (ERTM) or subcutaneous tissue (ERTT) were measured using high-resolution ultrasonography in 56 sarcopenic patients and 56 sex- and age- matched controls. The association between ultrasound measurements of the rotator cuff tendon complex and sarcopenia was investigated using the generalized estimating equation (GEE).Results: The sarcopenic group had an increased prevalence of shoulder pain. Based on the GEE analysis, sarcopenia was significantly associated with an increase in supraspinatus tendon thickness (β coefficient = 0.447, p < 0.001) and a decrease in the ERTM for the biceps long head and rotator cuff tendons. A negative trend of association was observed between sarcopenia and ERTT in the supraspinatus tendons (β coefficient = −0.097, p = 0.070). Nevertheless, sarcopenia was not associated with an increased risk of rotator cuff tendon tears.Conclusions: Patients with sarcopenia have a higher risk of shoulder pain. A consistent tendinopathic change develops in the supraspinatus tendons in sarcopenic patients. However, sarcopenia is less likely to be associated with serious rotator cuff pathology, such as tendon tears. Prospective cohort studies are warranted to explore the causal relationship between sarcopenia and shoulder disorders.
Highlights
Sarcopenia, characterized by aging-related gradual loss of muscle performance and function, has a prevalence of ∼10% in the population aged > 60 years [1]
There were no significant differences in bicep peritendinous effusion, subdeltoid bursitis, calcification, and partial/full-thickness tears of the three rotator cuff tendons (Table 1)
In terms of quantitative ultrasound measurements, the sarcopenic group presented with increased thickness and lower echogenicity ratio of tendon-to-muscle (ERTM) and echogenicity ratio of tendon-to-tissue (ERTT) of the supraspinatus tendons than those in the control group
Summary
Sarcopenia, characterized by aging-related gradual loss of muscle performance and function, has a prevalence of ∼10% in the population aged > 60 years [1]. The association between sarcopenia and musculoskeletal disorders has been uncovered in the recent years. In patients with lumbar spinal stenosis, sarcopenia was associated with an increased degree of vertebral slippage, more intense lower back pain, and a higher incidence of dyslipidemia and cardiovascular disease [7, 8]. A retrospective cohort study pointed out that grip strength, a widely used parameter for the diagnosis of sarcopenia, was a predictor for the risk of falls in patients following decompression and fusion for lumbar spinal stenosis [9]. Only a limited number of studies have investigated the relationship between sarcopenia and painful shoulder disorders
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