You are here

Article Text

Article menu
XML
Review
Is higher serum cholesterol associated with altered tendon structure or tendon pain? A systematic review
  1. Benjamin J Tilley1,
  2. Jill L Cook1,2,
  3. Sean I Docking1,2,
  4. James E Gaida1,3,4
  1. 1Department of Physiotherapy, Monash University, Melbourne, Victoria, Australia
  2. 2Australian Centre of Research into Injury in Sport and its Prevention (ACRISP), Federation University, Victoria, Australia
  3. 3Discipline of Physiotherapy, University of Canberra, Canberra, Australian Capital Territory, Australia
  4. 4University of Canberra, Research Institute for Sport and Exercise (UCRISE) Canberra, Australian Capital Territory, Australia
  1. Correspondence to Benjamin J Tilley, Monash University Peninsula Campus, McMahons Road, Frankston, VIC 3199, Australia; benjaminj.tilley18{at}gmail.com

Abstract

Background Tendon 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.

Objective To determine whether lipid levels are associated with abnormal tendon structure or the presence of tendon pain.

Methods We 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.

Results 17 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.

Conclusions The 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.

  • Cholesterol

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bjsports-2015-095100

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Supplementary materials

    • Supplementary Data

      This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

    • Press release

      Files in this Data Supplement: