Diabetes Metab J.  2023 Nov;47(6):869-878. 10.4093/dmj.2022.0275.

The Risk of Shoulder Adhesive Capsulitis in Individuals with Prediabetes and Type 2 Diabetes Mellitus: A Longitudinal Nationwide Population-Based Study

• Kim JH
• Kim BS
• Han Kd
• Kwon HS

• KMID: 2548163
• DOI: http://doi.org/10.4093/dmj.2022.0275

Abstract

Background
This study aimed to investigate the association between type 2 diabetes mellitus (T2DM) and shoulder adhesive capsulitis (AC) using a large-scale, nationwide, population-based cohort in the Republic of Korea.
Methods
A total of 3,471,745 subjects aged over 20 years who underwent a National Health Insurance Service medical checkup between 2009 and 2010 were included in this study, and followed from the date of their medical checkup to the end of 2018. Subjects were classified into the following four groups based on the presence of dysglycemia and history of diabetes medication: normal, prediabetes, newly diagnosed T2DM (new-T2DM), and T2DM (claim history for antidiabetic medication). The endpoint was new-onset AC during follow-up. The incidence rates (IRs) in 1,000 person-years and hazard ratios (HRs) of AC for each group were analyzed using Cox proportional hazard regression models.
Results
The IRs of AC were 9.453 (normal), 11.912 (prediabetes), 14.933 (new-T2DM), and 24.3761 (T2DM). The adjusted HRs of AC in the prediabetes, new-T2DM, and T2DM groups were 1.084 (95% confidence interval [CI], 1.075 to 1.094), 1.312 (95% CI, 1.287 to 1.337), and 1.473 (95% CI, 1.452 to 1.494) compared to the normal group, respectively. This secular trend of the HRs of AC according to T2DM status was statistically significant (P<0.0001).
Conclusion
This large-scale, longitudinal, nationwide, population-based cohort study of 3,471,745 subjects confirmed that the risk of AC increases in prediabetic subjects and is associated with T2DM status.

Keyword

Diabetes mellitus; Incidence; Risk factors; Prediabetic state; Shoulder; Stiffness

Figure

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  Fig. 1. Study design and patient characteristics. NHIS, National Health Insurance Service; T1DM, type 1 diabetes mellitus; T2DM, type 2 diabetes mellitus; FPG, fasting plasma glucose; DM, diabetes mellitus.

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  Fig. 2. (A) Incidence rate and (B) adjusted hazard ratio of shoulder adhesive capsulitis by duration of diabetes mellitus after adjusting for age, sex, smoking status, alcohol consumption, regular exercise, hypertension, dyslipidemia, and body mass index. All P for interaction <0.001. T2DM, type 2 diabetes mellitus.

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