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As a statistical method, the propensity score matching technique was used to select control group by 1:1 matching for age and sex. Inclusion criteria were patients who underwent arthroscopic repair for medium\u2010sized full\u2010thickness rotator cuff tears and those that were current smokers with a smoking history &gt;20 packs\/year. Patients lacking medium\u2010sized tears, those with recent steroid injection history, isolated subscapularis tear, preoperative stiff shoulder, acute traumatic tear, or previous surgery on the same shoulder, or those that declined to participate were excluded. Alterations in the expression of genes and proteins associated with myogenesis, inflammation, adipogenesis, and muscle fibrosis were compared between smokers and non\u2010smokers with reverse\u2010transcription quantitative polymerase chain reaction, western blotting, and immunohistochemistry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Histologic analysis revealed increased inflammation and remarkable fat accumulation and fibrogenesis in the rotator cuff muscle from smokers compared with that from non\u2010smokers. The mRNA expression levels of inflammatory high mobility group box 1 (\n                      <jats:italic>HMGB1<\/jats:italic>\n                      ;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .043), adipogenic CCAAT\/enhancer\u2010binding protein alpha (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .046) and peroxisome proliferator\u2010activated receptor gamma (\n                      <jats:italic>PPAR\u03b3<\/jats:italic>\n                      ;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .048), myogenic differentiation 1 (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .032), fibrogenic alpha\u2010smooth muscle actin (\n                      <jats:italic>\u03b1\u2010SMA<\/jats:italic>\n                      ;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .033), and metalloproteinase 9 (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .036) were significantly greater in samples from smokers than from non\u2010smokers. A correlation was observed between gene and protein expression of HMGB1 (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .034), PPAR\u03b3 (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .021), and \u03b1\u2010SMA (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .021).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Smokers with rotator cuff tears showed high inflammation, large fat infiltration, and fibrosis in rotator cuff muscle that is associated with the increased expression of HMGB1, PPAR\u03b3, and \u03b1\u2010SMA, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Case control study (Prognostic level III)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2019.06.037","type":"journal-article","created":{"date-parts":[[2019,11,27]],"date-time":"2019-11-27T10:34:41Z","timestamp":1574850881000},"page":"3181-3191","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":16,"title":["Influence of Smoking on the Expression of Genes and Proteins Related to Fat Infiltration, Inflammation, and Fibrosis in the Rotator Cuff Muscles of Patients With Chronic Rotator Cuff Tears: A Pilot Study"],"prefix":"10.1002","volume":"35","author":[{"given":"Yong\u2010Soo","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery Konkuk University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ja\u2010Yeon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Konkuk University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Se\u2010Young","family":"Ki","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Konkuk University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seok Won","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Konkuk University School of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,1]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/08870446.2017.1325890"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/4184190"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph8020613"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201410-1830PP"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.E.00899"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-009-0781-2"},{"key":"e_1_2_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514533776"},{"key":"e_1_2_2_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsem-2018-000416"},{"key":"e_1_2_2_10_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2010.524595"},{"key":"e_1_2_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2014.03.027"},{"key":"e_1_2_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518789691"},{"key":"e_1_2_2_13_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.17.00178"},{"key":"e_1_2_2_14_2","doi-asserted-by":"publisher","DOI":"10.1096\/fj.15-279588"},{"key":"e_1_2_2_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature00858"},{"key":"e_1_2_2_16_2","doi-asserted-by":"publisher","DOI":"10.2119\/molmed.2015.00087"},{"key":"e_1_2_2_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506297539"},{"key":"e_1_2_2_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.20695"},{"key":"e_1_2_2_19_2","doi-asserted-by":"publisher","DOI":"10.1242\/jcs.086629"},{"key":"e_1_2_2_20_2","doi-asserted-by":"publisher","DOI":"10.2741\/Perry"},{"key":"e_1_2_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/0092-8674(93)90621-V"},{"key":"e_1_2_2_22_2","doi-asserted-by":"publisher","DOI":"10.1101\/gad.10.10.1173"},{"key":"e_1_2_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semcdb.2005.07.006"},{"key":"e_1_2_2_24_2","first-page":"78","article-title":"Fatty muscle degeneration in cuff ruptures. 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