Is higher serum cholesterol associated with altered tendon structure or tendon pain? A systematic review

Abstract

BackgroundTendon pain occurs in individuals with extreme cholesterol levels (familial hypercholesterolaemia). It is unclear whether the association with tendon pain is strong with less extreme elevations of cholesterol.ObjectiveTo determine whether lipid levels are associated with abnormal tendon structure or the presence of tendon pain.MethodsWe conducted a systematic review and meta-analysis. Relevant articles were found through an electronic search of 6 medical databases—MEDLINE, Cochrane, AMED, EMBASE, Web of Science and Scopus. We included all case–control or cross-sectional studies with data describing (1) lipid levels or use of lipid-lowering drugs and (2) tendon structure or tendon pain.Results17 studies (2612 participants) were eligible for inclusion in the review. People with altered tendon structure or tendon pain had significantly higher total cholesterol, low-density lipoprotein cholesterol and triglycerides, as well as lower high-density lipoprotein cholesterol; with mean difference values of 0.66, 1.00, 0.33, and −0.19 mmol/L, respectively.ConclusionsThe results of this review indicate that a relationship exists between an individual’s lipid profile and tendon health. However, further longitudinal studies are required to determine whether a cause and effect relationship exists between tendon structure and lipid levels. This could lead to advancement in the understanding of the pathoaetiology and thus treatment of tendinopathy.

Is there an association between tendinopathy and diabetes mellitus? A systematic review with meta-analysis

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Conservative treatments for greater trochanteric pain syndrome: a systematic review

“…The Cochrane Colloquium, 2014). Prognostic factors were high baseline disability,28 long duration of symptoms prior to intervention,2 28 higher initial pain intensity,28 older age,28 OA,2 previous treatment2 and general health issues such as diabetes mellitus29 and hypercholesterolaemia 30 31. Lievense et al 2 found that patients with osteoarthritis were 4.8 times more likely to have symptoms at 1 year, while patients that had previously received injections for GTPS were 2.7 times more likely to recover at 5 years.…”

Rotator cuff pathology: state of the art

“…A systematic review18 demonstrated that individuals with an adverse lipid profile might have an increased risk to cause tendon pathologies including rotator cuff tear. The meta-analysis revealed higher serum levels of total cholesterol (TC), low-density lipoprotein cholesterol and triglycerides as well as lower levels of high-density lipoprotein cholesterol in those with the Achilles tendinopathy or rotator cuff tears 18. In addition, chronic alcohol consumption has also shown to be associated with the prevalence of rotator cuff tears.…”