Experimental Study On The Influence Of Diabetes On The Cause Of Scapulohumeral Periarthritis

【Objective】Scapulohumeral periarthritis, or periarthritis of shoulder, is a common and frequently-occurring disease for middle-aged and old people. Its main symptoms are omodynia and dysfunction. Clinicians have accumulated much experience in the treatment of this disease. However, the cause of scapulohumeral periarthritis remains unclear. Most scholars think the cause of this disease is inseparably related to the structural characteristics of shoulder joint, degenerative diseases and kinetic factors. In addition, clinical data indicate that systemic diseases of lesion are closely connected with the cause of scapulohumeral periarthritis, and it has been proved that rheumatism and rheumatoid diseases may cause scapulohumeral periarthritis. Among the 330 sufferers from scapulohumeral periarthritis treated by our section from 2003 to 2008, 60 people also suffered from diabetes, which accounts for 18% of the total number. Such a great percentage caused our concern. The diabetes is also a kind of systemic disease of lesion. At present, in the research on diabetes at home and abroad, much has been done on its influence on the chronic pathological changes in heart, kidney, blood vessels, nerves, eyes etc. , which are caused by pathological changes in great vessels, micrangium and nerve. However, little research has been done on the harm of diabetes to kinetic system, except that on osteoporosis. No report has been made that diabetes may lead to scapulohumeral periarthritis. In order to understand the potential internal links between diabetes and scapulohumeral periarthritis, we designed the experimental research on the influence of diabetes on the cause of scapulohumeral periarthritis. Through observing in experiments the different degrees of damage that diabetes does to bone joints, we intend to verify the internal links between diabetes and scapulohumeral periarthritis.【Methods】Select some healthy Sprague-Dawley male rats, divide them randomly into two groups (A and B). The rats in Group A serve as the controls. The rats in Group B are injected intraperitoneally with streptozocin to establish the diabetes model. Kill the model of diabetes (Group B) in 8 weeks, take the joints, compare them with those of the controls (Group A), and observe the pathological changes of the joints under the light microscope.【Results】The rate of cataplasia of the joints in Group A increased obviously. The difference between these two groups bears statistical significance (p<0.01). The synovial villus in the joints of the model of diabetes became hypertrophic and fibrotic; there were hypertrophy and hyperplasia in synovial cells; lymphocytes and monocytes had adhesive infiltration ; the articular cartilage was fibrotic―there was superficial dehiscence in the extracellular matrix; the cartilage looked like velvet; the chondrocyte apoptosis was obvious; there was an increase in the number of cartilage cells around the chondromalacia patellae; the affinity of the matrix around the cartilage lacuna to hematoxylin increased; in the ligament of the model group some ruptured collagen fibers with big diameters could be seen. Through the experiments it could be seen that the degenerative changes caused by diabetes are similar to the normal cataplasia and early stages of rheumatism or rheumatoid diseases. Diabetes can cause microangiopathy and endocrine disturbances, and it may lead to damages of soft tissues such as muscle, tendon, fascia and articular capsule. At the same time, tissue regeneration decreases, and this accelerates the cataplasia of shoulder joints and surrounding soft tissue, laying the pathologic basis for the formation of scapulohumeral periarthritis. The above analysis revealed the internal links between diabetes and scapulohumeral periarthritis and provided a theoretical basis. .