Obesity is an Independent Risk Factor for Achilles Tendon Rupture: A Nationwide Longitudinal Cohort Study in South Korea

Abstract

Category: Hindfoot; Sports Introduction/Purpose: Obesity is an increasing comorbidity that can negatively affect the clinical outcomes of various disease in orthopaedics. However, there was no study to evaluate an association between Achilles tendon rupture and obesity in a nationwide study. We aimed to investigate the incidence of Achilles tendon rupture through a nationwide longitudinal cohort in Korea and evaluate the influences of demographic data including body mass index (BMI). Methods: Between 2002 and 2015, sociodemographic factors including gender, age, BMI, income, comorbidities, and sport activity level were retrieved from National Health Insurance Service-National Sample Cohort (NHIS-NSC). NHIS-NSC database was searched for individuals treated with ATR. We excluded individuals who were less than 20 years-old. Results: 736 (0.116%) of total 636,921 individuals in NHIS-NSC database underwent Achilles tendon repair (ATR). Multivariable logistic regression analysis revealed that obesity (BMI>= 25kg/m 2 ) was significantly associated with ATR (odds ratio, 1.99; 95% confidence interval, 1.68 to 2.36). Other significant factors were age, male, total cholesterol, moderate sport activity, and income. After propensity score matching of all factors, obesity was significantly associated with ATR with odds ratio 1.95 (95% confidence interval, 1.60 to 2.39). Conclusion: Obesity is an independent predictive factor for the occurrence of Achilles tendon rupture followed by ATR.