Riley et al. (1994). proposed a theory suggesting that ischemic injury and rotator cuff degeneration associated with metabolic diseases lead to further calcification, indicating that metabolic diseases may be related to calcific tendinopathy. Chen et al. (2024) demonstrated that dysregulated glucose and lipid metabolism can activate the CXCL13-CXCR5 axis in aged TDSCs, thereby promoting ectopic ossification. The gene discussed is CXCL13; the disease is metabolic disease.