{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T22:19:24Z","timestamp":1791670764219,"version":"4.3.4"},"reference-count":56,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","license":[{"start":{"date-parts":[[2018,8,15]],"date-time":"2018-08-15T00:00:00Z","timestamp":1534291200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2018,8,15]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Certain metabolic factors have been proposed as risk factors for a posterosuperior rotator cuff tear. Although metabolic syndrome is of increasing concern in industrialized societies, little information exists regarding its association with posterosuperior rotator cuff tears. The purpose of this study was to determine the risk factors for an atraumatic posterosuperior rotator cuff tear, including metabolic factors and metabolic syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This study involved 634 subjects (634 shoulders) drawn from a cohort of rural residents. Posterosuperior rotator cuff tear diagnoses were based on magnetic resonance imaging (MRI) findings. Logistic regression analysis was used to determine the odds ratios (ORs) and 95% confidence intervals (CIs) for various demographic, physical, and social factors, including age, sex, dominant-side involvement, body mass index (BMI), and participation in manual labor; the comorbidities of diabetes, hypertension, dyslipidemia, thyroid dysfunction, ipsilateral carpal tunnel syndrome, and metabolic syndrome; and the serum metabolic parameters of serum lipid profile, glycosylated hemoglobin A1c, and level of thyroid hormone. Two multivariable analyses were performed: the first excluded metabolic syndrome while including diabetes, hypertension, BMI, and hypo-high-density lipoproteinemia (hypo-HDLemia), and the second included metabolic syndrome while excluding the formerly included variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Age, BMI, waist circumference, dominant-side involvement, manual labor, diabetes, hypertension, metabolic syndrome, ipsilateral carpel tunnel syndrome, HDL (high-density lipoprotein), and hypo-HDLemia were significantly associated with posterosuperior rotator cuff tears in univariate analyses (p \u2264 0.035). In the first multivariable analysis, age (OR. 1.86 [95% CI, 1.47 to 2.35]), BMI (OR, 1.09 [95% CI, 1.02 to 1.18]), dominant-side involvement (OR, 2.04 [95% CI, 1.38 to 3.01]), manual labor (OR, 9.48 [95% CI, 5.13 to 17.51]), diabetes (OR, 3.38 [95% CI, 1.98 to 5.77]), and hypo-HDLemia (OR, 2.07 [95% CI, 1.30 to 3.29]) were significantly associated with posterosuperior rotator cuff tears (p \u2264 0.019). In the second multivariable analysis, age (OR, 1.85 [95% CI, 1.48 to 2.31]), dominant-side involvement (OR, 1.83 [95% CI, 1.26 to 2.67]), manual labor (OR, 7.71 [95% CI, 4.33 to 13.73]), and metabolic syndrome (OR, 1.98 [95% CI, 1.35 to 2.91]) were significantly associated with posterosuperior rotator cuff tears (p \u2264 0.002).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The metabolic factors of diabetes, BMI, hypo-HDLemia, and metabolic syndrome were significant independent factors associated with the development of posterosuperior rotator cuff tears.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.16.01592","type":"journal-article","created":{"date-parts":[[2018,8,16]],"date-time":"2018-08-16T01:45:50Z","timestamp":1534383950000},"page":"1397-1405","source":"Crossref","is-referenced-by-count":62,"title":["Factors Associated with Atraumatic Posterosuperior Rotator Cuff Tears"],"prefix":"10.2106","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9468-6282","authenticated-orcid":false,"given":"Hyung Bin","family":"Park","sequence":"first","affiliation":[{"name":"Departments of Orthopaedic Surgery (H.B.P., J.-Y.G., and J.-H.I.) and Internal Medicine (J.J.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Yong","family":"Gwark","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery (H.B.P., J.-Y.G., and J.-H.I.) and Internal Medicine (J.J.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Hyung","family":"Im","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery (H.B.P., J.-Y.G., and J.-H.I.) and Internal Medicine (J.J.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaehoon","family":"Jung","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedic Surgery (H.B.P., J.-Y.G., and J.-H.I.) and Internal Medicine (J.J.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Boem","family":"Na","sequence":"additional","affiliation":[{"name":"Departments of Radiology (J.-B.N.) and Rehabilitation Medicine (C.H.Y.), Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chul Ho","family":"Yoon","sequence":"additional","affiliation":[{"name":"Departments of Radiology (J.-B.N.) and Rehabilitation Medicine (C.H.Y.), Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,8,15]]},"reference":[{"issue":"2","key":"bib1-20230714","first-page":"70","article-title":"Clinical and biological aspects of rotator cuff tears","volume":"3","author":"Via","year":"2013","journal-title":"Muscles Ligaments Tendons J."},{"issue":"1","key":"bib2-20230714","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.jse.2009.04.006","article-title":"Prevalence and risk factors of a rotator cuff tear in the general population","volume":"19","author":"Yamamoto","year":"2010","journal-title":"J Shoulder Elbow Surg."},{"issue":"5","key":"bib3-20230714","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1002\/art.22222","article-title":"Epidemiologic surveillance of upper-extremity musculoskeletal disorders in the working population","volume":"55","author":"Roquelaure","year":"2006","journal-title":"Arthritis Rheum."},{"issue":"2","key":"bib4-20230714","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.jse.2015.07.005","article-title":"Genome-wide association study for rotator cuff tears identifies two significant single-nucleotide polymorphisms","volume":"25","author":"Tashjian","year":"2016","journal-title":"J Shoulder Elbow Surg."},{"issue":"4","key":"bib5-20230714","doi-asserted-by":"crossref","first-page":"743","DOI":"10.2106\/00004623-200404000-00011","article-title":"Associations between body-mass index and surgery for rotator cuff tendinitis","volume":"86","author":"Wendelboe","year":"2004","journal-title":"J Bone Joint Surg Am."},{"issue":"11","key":"bib6-20230714","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1016\/j.jse.2014.03.016","article-title":"The association between body fat and rotator cuff tear: the influence on rotator cuff tear sizes","volume":"23","author":"Gumina","year":"2014","journal-title":"J Shoulder Elbow Surg."},{"issue":"6","key":"bib7-20230714","doi-asserted-by":"crossref","first-page":"S269","DOI":"10.1016\/j.otsr.2015.06.011","article-title":"French Society For Shoulder and Elbow (SOFEC). 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