Dataset Information

Low serum vitamin B₁₂ levels are associated with degenerative rotator cuff tear.

ABSTRACT:

Background

Vitamin B₁₂ (Vit B₁₂) deficiency results in elevated homocysteine levels and interference with collagen cross-linking, which may affect tendon integrity. The purpose of this study was to investigate whether serum Vit B₁₂ levels were correlated with degenerative rotator cuff (RC) tear.

Methods

Eighty-seven consecutive patients with or without degenerative RC tear were enrolled as study participants. Possible risk factors (age, sex, medical history, bone mineral density, and serum chemistries including glucose, magnesium, calcium, phosphorus, zinc, homocysteine, Vitamin D, Vit B₁₂, homocysteine, and folate) were assessed. Significant variables were selected based on the results of univariate analyses, and a logistic regression model (backward elimination) was constructed to predict the presence of degenerative RC tear.

Results

In the univariate analysis, the group of patients with degenerative RC tear had a mean concentration of 528.4 pg/mL Vit B₁₂, which was significantly lower than the healthy control group (627.1 pg/mL). Logistic regression analysis using Vit B₁₂ as an independent variable revealed that Vit B₁₂ concentrations were significantly correlated with degenerative RC tear (p = 0.044). However, Vit B₁₂ levels were not associated with tear size.

Conclusion

Low serum levels of Vit B₁₂ were independently related to degenerative RC tear. Further investigations are warranted to determine if Vit B₁₂ supplementation can decrease the risk of this condition.

SUBMITTER: Kim JH

PROVIDER: S-EPMC8053277 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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Publications

Low serum vitamin B<sub>12</sub> levels are associated with degenerative rotator cuff tear.

Kim Jae Hwa JH Kim Go-Tak GT Yoon Siyeoung S Lee Hyun Il HI Ko Kyung Rae KR Lee Sang-Cheol SC Kim Do Kyung DK Shin Jaeyeon J Lee So-Young SY Lee Soonchul S

BMC musculoskeletal disorders 20210417 1

<h4>Background</h4>Vitamin B<sub>12</sub> (Vit B<sub>12</sub>) deficiency results in elevated homocysteine levels and interference with collagen cross-linking, which may affect tendon integrity. The purpose of this study was to investigate whether serum Vit B<sub>12</sub> levels were correlated with degenerative rotator cuff (RC) tear.<h4>Methods</h4>Eighty-seven consecutive patients with or without degenerative RC tear were enrolled as study participants. Possible risk factors (age, sex, medica ...[more]

PMID: 33865356

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Project description:BackgroundThe 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.MethodsThis 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) ≥ 3.5. Logistic regression analysis was used to determine the association between fasting glucose level, TG/HDL ≥ 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.ResultsIn the multivariable analyses, both scale and categorical values of fasting glucose levels, and TG/HDL ≥ 3.5 were significantly associated with degenerative RCT. Fasting glucose levels ≥ 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 ≥ 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).ConclusionsHigh 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 evidenceLevel III, prognostic study.

Project description:Myosteatosis is the pathological accumulation of lipid that occurs in conjunction with atrophy and fibrosis following skeletal muscle injury or disease. Little is known about the mechanisms by which lipid accumulates in myosteatosis, but many studies have demonstrated the degree of lipid infiltration negatively correlates with muscle function and regeneration. Our goal was to identify biochemical pathways that lead to muscle dysfunction and lipid accumulation in injured rotator cuff muscles, a model that demonstrates severe myosteatosis. Adult rats were subjected to a massive tear to the rotator cuff musculature. After a period of either 0 (healthy control), 10, 30, or 60 days, muscles were prepared for RNA sequencing, shotgun lipidomics, metabolomics, biochemical measures, electron microscopy, and muscle fiber contractility. Following rotator cuff injury, there was a decrease in muscle fiber specific force production that was lowest at 30d. There was a dramatic time dependent increase in triacylglyceride content. Interestingly, genes related to not only triacylglyceride synthesis, but also lipid oxidation were largely downregulated over time. Using bioinformatics techniques, we identified that biochemical pathways related to mitochondrial dysfunction and reactive oxygen species were considerably increased in muscles with myosteatosis. Long chain acyl-carnitines and L-carnitine, precursors to beta-oxidation, were depleted following rotator cuff tear. Electron micrographs showed injured muscles displayed large lipid droplets within mitochondria at early time points, and an accumulation of peripheral segment mitochondria at all time points. Several markers of oxidative stress were elevated following rotator cuff tear. The results from this study suggest that the accumulation of lipid in myosteatosis is not a result of canonical lipid synthesis, but occurs due to decreased lipid oxidation in mitochondria. A failure in lipid utilization by mitochondria would ultimately cause an accumulation of lipid even in the absence of increased synthesis. Further study will identify whether this process is required for the onset of myosteatosis.

Project description:Backgrounds Osteoporosis (OP) is an important risk factor for rotator cuff tears (RCTs). However, the relationship and mechanism between rotator cuff injury and osteoporosis are unclear. Therefore, to investigate association between rotator cuff injury and osteoporosis, and find clinical characteristics, bone mineral density, bone metabolism markers, and nutrient levels in rotator cuff injury patients with or without osteoporosis. Methods One hundred and four cases of patients (RCTs, n=32; RCTs-OP, n=72) who underwent rotator cuff injury and need arthroscopic rotator cuff repair between June 2021 and February 2022, along with the diagnosis of osteoporosis were identified from the dual-energy X-ray bone density screening(DXA). The outcome measure includes clinical characteristics, bone mineral density, bone metabolism markers, vitamins, and amino acids. Multivariable logistic regression analysis was applied to build a predicting model incorporating the feature selected in the least absolute shrinkage and selection operator regression model. Discrimination, calibration, and clinical usefulness of the predicting model were assessed using the C-index, calibration plot, and decision curve analysis. Internal validation was assessed using bootstrapping validation. Results OP with RCTs has a lower level of in 25-vitD, osteocalcin (OCN), serum Ca2+, ornithine, diaminocaproic_acid but the high level of Vitamin_B12, PTH, Vitamin_D3,γ_aminobutyric_acid, Vitamin_C and Vitamin_E than RCTs patients without OP. Predictors contained in the prediction nomogram included lumber T score, femur T score, Niacin_B3, and vitamin D, reflecting the combined effect of vitamins on RCTs-related OP progression. The model has good discriminative ability with a C-index of 0.938(95% CI:-1.83-1.39) and good scaling ability. The high C-index value of 0.95 is still achievable with range validation. Analysis of decision curves showed that non-adherence is clinically useful when intervention decisions are at the 14% probability limit of non-adherence. Conclusion This study supports the hypothesis that lumber T score, femur T score, Niacin_B3, and Vitamin D are valuable prognostic biomarkers on RCTs related OP progression. What is known about the subject It is found that vitamin D are valuable prognostic biomarkers, reflecting the combined effect of vitamins on RCTs related OP progression. What this study adds to existing knowledge These findings also highlight that nutrients condition such as vitamins and amino acids of patients provide a new understanding of the development of RCTs.

Project description:ObjectivesDegenerative rotator cuff tears (DCTs) are the leading cause of shoulder pain, affecting 30%-50% of individuals over 50. Current phenotyping strategies for DCT use heterogeneous combinations of procedural and diagnostic codes and are concerning for misclassification. The objective of this study was to create standardized phenotypic algorithms to classify DCT status across electronic health record (EHR) systems.Materials and methodsUsing a de-identified EHR system, containing chart level data for ∼3.5 million individuals from January 1998 to December 2023, we developed and validated 2 types of algorithms-one requiring and one without imaging verification-to identify DCT cases and controls. The algorithms used combinations of International Classification of Diseases (ICD) / Current Procedural Terminology (CPT) codes and natural language processing (NLP) to increase diagnostic certainty. These hand-crafted algorithms underwent iterative refinement with manual chart review by trained personnel blinded to case-control determinations to compute positive predictive value (PPV) and negative predictive value (NPV).ResultsThe algorithm development process resulted in 5 algorithms to identify patients with or without DCT with an overall predictive value of 94.5%: (1) code only cases that required imaging confirmation (PPV = 89%), (2) code only cases that did not require imaging verification (PPV = 92%), (3) NLP-based cases that did not require imaging verification (PPV = 89%), (4) code-based controls that required imaging confirmation (NPV = 90%), and (5) code and NLP-based controls that did not require imaging verification (NPV = 100%). External validation demonstrated 94% sensitivity and 75% specificity for the code-only algorithms.DiscussionThis work highlights the inaccuracy of previous approaches to phenotypic assessment of DCT reliant solely on ICD and CPT codes and demonstrate that integrating temporal and frequency requirements, as well as NLP, substantially increases predictive value. However, while the inclusion of imaging verification enhances diagnostic confidence, it also reduces sample size without necessarily improving predictive value, underscoring the need for a balance between precision and scalability in phenotypic definitions for large-scale genetic and clinical research.ConclusionsThese algorithms represent an improvement over prior DCT phenotyping strategies and can be useful in large-scale EHR studies.

Project description:Rotator cuff (RC) tears are prevalent in the population above the age of 60. The disease progression leads to muscle atrophy, fibrosis, and fatty infiltration in the chronic state, which is not improved with intervention or surgical repair. This highlights the need to better understand the underlying dysfunction in muscle after RC tendon tear. Contemporary studies aimed at understanding muscle pathobiology after RC tear have considered transcriptional data in mice, rats and sheep models at 2-3 time points (1 to 16 weeks post injury). However, none of these studies observed a transition or resurgence of gene expression after the initial acute time points. In this study, we collected rabbit supraspinatus muscle tissue with high temporal resolution (1, 2, 4, 8, and 16 weeks) post-tenotomy (n = 6/group), to determine if unique, time-dependent transcriptional changes occur. RNA sequencing and analyses were performed to identify a transcriptional timeline of RC muscle changes and related morphological sequelae. At 1-week post-tenotomy, the greatest number of differentially expressed genes was observed (1,069 up/873 down) which decreases through 2 (170/133), 4 (86/41), and 8 weeks (16/18), followed by a resurgence and transition of expression at 16 weeks (1,421/293), a behavior which previously has not been captured or reported. Broadly, 1-week post-tenotomy is an acute time point with expected immune system responses, catabolism, and changes in energy metabolism, which continues into 2 weeks with less intensity and greater contribution from mitochondrial effects. Expression shifts at 4 weeks post-tenotomy to fatty acid oxidation, lipolysis, and general upregulation of adipogenesis related genes. The effects of previous weeks' transcriptional dysfunction present themselves at 8 weeks post-tenotomy with enriched DNA damage binding, aggresome activity, extracellular matrix-receptor changes, and significant expression of genes known to induce apoptosis. At 16 weeks post-tenotomy, there is a range of enriched pathways including extracellular matrix constituent binding, mitophagy, neuronal activity, immune response, and more, highlighting the chaotic nature of this time point and possibility of a chronic classification. Transcriptional activity correlated significantly with histological changes and were enriched for biologically relevant pathways such as lipid metabolism. These data provide platform for understanding the biological mechanisms of chronic muscle degeneration after RC tears.

Dataset Information

Low serum vitamin B₁₂ levels are associated with degenerative rotator cuff tear.

Background

Methods

Results

Conclusion

Publications

Low serum vitamin B<sub>12</sub> levels are associated with degenerative rotator cuff tear.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

Low serum vitamin B12 levels are associated with degenerative rotator cuff tear.

Background

Methods

Results

Conclusion

Publications

Low serum vitamin B<sub>12</sub> levels are associated with degenerative rotator cuff tear.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Low serum vitamin B₁₂ levels are associated with degenerative rotator cuff tear.