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

Introduction: 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. Materials and methods: 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. Results: 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. Conclusion: 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.