Beyond Overuse: A Cross-Sectional Analysis of Insulin Resistance in De Quervain's and Stenosing Flexor Tenosynovitis

Insulin resistance (IR) or metabolic syndrome (MetS) may escalate the propensity for tenosynovitis from accrual of advanced glycation end products from chronic hyperglycaemia. This study characterised IR/MetS among patients with de Quervain's tenosynovitis (DQT) and trigger finger (TF) or stenosing flexor tenosynovitis in a clinical practice setting.

A prospective, non-interventional, cross-sectional study enrolled 118 patients with DQT or TF at a general orthopaedics-hand surgery practice. IR/MetS was defined using established criteria, including HbA1c levels, a prior diagnosis of prediabetes (PD) or type 2 diabetes (T2D), and Japanese diagnostic guidelines. The proportion of IR was analysed using descriptive statistics. Patient characteristics and metabolic parameters were summarised and compared between IR and non-IR groups.

Of 93 patients included in the final analysis, 65 (70%) were insulin resistant. Among IR patients, 47% had PD, and 23% had T2D. No significant gender differences were observed. Patients with IR had higher mean BMI, blood uric acid, fasting blood sugar, HbA1c, and TG:HDL-C ratios compared to non-IR patients. The distribution of TF and DQT was similar between groups.

This study describes the metabolic profile of patients with tenosynovitis, revealing a high proportion of IR/MetS. These findings highlight metabolic dysfunction as a potential factor in chronic tendinopathies and underscore the need for further research into underlying mechanisms and targeted interventions.