Association between adhesive capsulitis and thyroid disease: a meta-analysis.
Level 4 - case-series / case-control
Systematic review and meta-analysis of case-control studies (CEBM Level 4)
PubMed 36871608 · doi:10.1016/j.jse.2023.01.033
What was done
Authors searched PubMed, Embase, and Scopus up to September 20, 2022, for studies evaluating the link between adhesive capsulitis (AC) and thyroid disease. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated across all included studies and stratified by thyroid disease subtype (hypothyroidism, subclinical hypothyroidism, and hyperthyroidism). Heterogeneity and publication bias were assessed.
What was found
The meta-analysis included 10 case-control studies with 127,967 patients. Thyroid disease prevalence was significantly higher in patients with AC compared to controls (OR = 1.87, 95% CI: 1.37–2.57, P < .0001). Subgroup analyses showed significant associations with hypothyroidism (OR = 1.92, 95% CI: 1.09–3.39, P = .02) and subclinical hypothyroidism (OR = 2.56, 95% CI: 1.81–3.63, P < .00001), but not hyperthyroidism (OR = 1.42, 95% CI: 0.63–3.22, P = .40).
Why it matters
This review aggregates epidemiological data confirming a strong association between adhesive capsulitis and hypothyroidism or subclinical hypothyroidism, supporting clinical awareness of thyroid dysfunction in patients presenting with frozen shoulder.
Limits
All 10 included datasets were case-control studies, which cannot establish temporality or causality. The analysis for hyperthyroidism had few studies and lacked statistical power. The abstract does not report adjustment for key confounders like diabetes mellitus or age.
Cited by
- supports Hypothyroidism is associated with and can present as frozen shoulder and tendon tears.