Influence of the metabolic and inflammatory profile in patients with frozen shoulder - systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies examining metabolic and inflammatory biomarkers in frozen shoulder
PubMed 40375116 · doi:10.1186/s12891-025-08706-9
What was done
The authors conducted a systematic review and meta-analysis investigating metabolic and inflammatory biomarkers in patients with frozen shoulder (adhesive shoulder capsulitis). Variables evaluated included glycemic markers (HbA1c, glucose), lipids (cholesterol, triglycerides), thyroid dysfunction (hypothyroidism), and inflammatory cytokines (IL-1β, IL-6, TNF-α). The meta-analysis encompassed 7,499 individuals, with an additional study evaluating 28,416 biobank blood samples.
What was found
Frozen shoulder was significantly associated with elevations in: - HbA1c: standardized mean difference (SMD) = 0.3970 (95% CI: 0.0998 to 0.6943) - Cholesterol: standardized difference = 0.278 (95% CI: 0.171 to 0.385) - IL-1β: SMD = 2.2671 (95% CI: 0.5750 to 3.9591) - TNF-α: mean difference = 0.7814 (95% CI: 0.1013 to 1.4615, p = 0.0243) No significant associations were observed for: - Glucose: mean difference = -0.28 (95% CI: -0.60 to 0.05) - Triglycerides: SMD = 1.0318 (95% CI: -1.0027 to 3.0664, marked by high heterogeneity) - IL-6: SMD = 1.6721 (95% CI: -0.9368 to 4.2810) - Hypothyroidism: SMD = 0.067 (95% CI: -0.024 to 0.158)
Why it matters
This synthesis demonstrates that frozen shoulder is associated with systemic chronic inflammation (IL-1β, TNF-α) and long-term metabolic dysfunction (HbA1c, cholesterol) rather than acute glycemic changes or thyroid dysfunction.
Limits
The total number and designs of individual studies are not reported in the abstract. Several inflammatory and lipid markers (triglycerides, IL-6) exhibited wide confidence intervals and high heterogeneity, preventing definitive conclusions. Because the underlying data are observational, causation cannot be established.
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