Dyslipidemia in Achilles tendinopathy is characteristic of insulin resistance

James Gaida, Lotta Alfredson, Zoltan Steven Kiss, Andrew Michael Wilson, Håkan Alfredson, Jill Leigh Cook

    Research output: Contribution to journalArticle

    71 Citations (Scopus)

    Abstract

    UNLABELLED: Overuse is considered to be a main causative factor for tendinopathies; however, recent reports indicate that tendinopathy is also common among both overweight and inactive individuals. These factors are associated with abdominal obesity, dyslipidemia, hypertension, and insulin resistance. We hypothesized that these features would be associated with tendinopathy. PURPOSE: To compare lipid profile between participants with Achilles tendinopathy and matched controls. METHODS: Fasting serum lipids were measured among 60 participants with chronic painful midportion Achilles tendinopathy (54% male) and 60 control subjects matched for gender, age (+/-10 yr), and body mass index (+/-2 kg x m(-2)). RESULTS: The participants with Achilles tendinopathy showed evidence of underlying dyslipidemia. They had higher triglyceride (TG) levels (P = 0.039), lower %HDL-C (P = 0.016), higher TG/HDL-C ratio (P = 0.036), and elevated apolipoprotein B concentration (P = 0.017) in comparison to the well-matched control group. CONCLUSIONS: This pattern of dyslipidemia is characteristic of the dyslipidemia displayed by individuals with insulin resistance and is common in the metabolic syndrome. Two additional aspects of tendinopathy research support a connection with the metabolic syndrome. First, tendinopathy has been associated with greater waist circumference, as has the metabolic syndrome. Second, insulin resistance has been associated with fat deposition in muscle (primarily intracellular), whereas fat deposition in tendon has been found among those with tendon pain.If tendinopathy is confirmed to be associated with dyslipidemia and the metabolic syndrome in larger studies, it may be appropriate to redefine our concept of tendinopathy to that of a cardiovascular disease (CVD). In this case, we may be able to draw considerably on CVD research to improve our understanding of tendinopathy, and perhaps treating CVD risk factors will improve the treatment of tendinopathy.

    Original languageEnglish
    Pages (from-to)1194-1197
    Number of pages4
    JournalMedicine and Science in Sports and Exercise
    Volume41
    Issue number6
    DOIs
    Publication statusPublished - Jun 2009

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    Tendinopathy
    Dyslipidemias
    Insulin Resistance
    Cardiovascular Diseases
    Tendons
    Triglycerides
    Fats
    Lipids
    Abdominal Obesity
    Apolipoproteins B
    Waist Circumference
    Fasting
    Body Mass Index
    Research Design

    Cite this

    Gaida, James ; Alfredson, Lotta ; Kiss, Zoltan Steven ; Wilson, Andrew Michael ; Alfredson, Håkan ; Cook, Jill Leigh. / Dyslipidemia in Achilles tendinopathy is characteristic of insulin resistance. In: Medicine and Science in Sports and Exercise. 2009 ; Vol. 41, No. 6. pp. 1194-1197.
    @article{e26337e55056430693870a5682599544,
    title = "Dyslipidemia in Achilles tendinopathy is characteristic of insulin resistance",
    abstract = "UNLABELLED: Overuse is considered to be a main causative factor for tendinopathies; however, recent reports indicate that tendinopathy is also common among both overweight and inactive individuals. These factors are associated with abdominal obesity, dyslipidemia, hypertension, and insulin resistance. We hypothesized that these features would be associated with tendinopathy. PURPOSE: To compare lipid profile between participants with Achilles tendinopathy and matched controls. METHODS: Fasting serum lipids were measured among 60 participants with chronic painful midportion Achilles tendinopathy (54{\%} male) and 60 control subjects matched for gender, age (+/-10 yr), and body mass index (+/-2 kg x m(-2)). RESULTS: The participants with Achilles tendinopathy showed evidence of underlying dyslipidemia. They had higher triglyceride (TG) levels (P = 0.039), lower {\%}HDL-C (P = 0.016), higher TG/HDL-C ratio (P = 0.036), and elevated apolipoprotein B concentration (P = 0.017) in comparison to the well-matched control group. CONCLUSIONS: This pattern of dyslipidemia is characteristic of the dyslipidemia displayed by individuals with insulin resistance and is common in the metabolic syndrome. Two additional aspects of tendinopathy research support a connection with the metabolic syndrome. First, tendinopathy has been associated with greater waist circumference, as has the metabolic syndrome. Second, insulin resistance has been associated with fat deposition in muscle (primarily intracellular), whereas fat deposition in tendon has been found among those with tendon pain.If tendinopathy is confirmed to be associated with dyslipidemia and the metabolic syndrome in larger studies, it may be appropriate to redefine our concept of tendinopathy to that of a cardiovascular disease (CVD). In this case, we may be able to draw considerably on CVD research to improve our understanding of tendinopathy, and perhaps treating CVD risk factors will improve the treatment of tendinopathy.",
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    author = "James Gaida and Lotta Alfredson and Kiss, {Zoltan Steven} and Wilson, {Andrew Michael} and H{\aa}kan Alfredson and Cook, {Jill Leigh}",
    year = "2009",
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    Dyslipidemia in Achilles tendinopathy is characteristic of insulin resistance. / Gaida, James; Alfredson, Lotta; Kiss, Zoltan Steven; Wilson, Andrew Michael; Alfredson, Håkan; Cook, Jill Leigh.

    In: Medicine and Science in Sports and Exercise, Vol. 41, No. 6, 06.2009, p. 1194-1197.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Dyslipidemia in Achilles tendinopathy is characteristic of insulin resistance

    AU - Gaida, James

    AU - Alfredson, Lotta

    AU - Kiss, Zoltan Steven

    AU - Wilson, Andrew Michael

    AU - Alfredson, Håkan

    AU - Cook, Jill Leigh

    PY - 2009/6

    Y1 - 2009/6

    N2 - UNLABELLED: Overuse is considered to be a main causative factor for tendinopathies; however, recent reports indicate that tendinopathy is also common among both overweight and inactive individuals. These factors are associated with abdominal obesity, dyslipidemia, hypertension, and insulin resistance. We hypothesized that these features would be associated with tendinopathy. PURPOSE: To compare lipid profile between participants with Achilles tendinopathy and matched controls. METHODS: Fasting serum lipids were measured among 60 participants with chronic painful midportion Achilles tendinopathy (54% male) and 60 control subjects matched for gender, age (+/-10 yr), and body mass index (+/-2 kg x m(-2)). RESULTS: The participants with Achilles tendinopathy showed evidence of underlying dyslipidemia. They had higher triglyceride (TG) levels (P = 0.039), lower %HDL-C (P = 0.016), higher TG/HDL-C ratio (P = 0.036), and elevated apolipoprotein B concentration (P = 0.017) in comparison to the well-matched control group. CONCLUSIONS: This pattern of dyslipidemia is characteristic of the dyslipidemia displayed by individuals with insulin resistance and is common in the metabolic syndrome. Two additional aspects of tendinopathy research support a connection with the metabolic syndrome. First, tendinopathy has been associated with greater waist circumference, as has the metabolic syndrome. Second, insulin resistance has been associated with fat deposition in muscle (primarily intracellular), whereas fat deposition in tendon has been found among those with tendon pain.If tendinopathy is confirmed to be associated with dyslipidemia and the metabolic syndrome in larger studies, it may be appropriate to redefine our concept of tendinopathy to that of a cardiovascular disease (CVD). In this case, we may be able to draw considerably on CVD research to improve our understanding of tendinopathy, and perhaps treating CVD risk factors will improve the treatment of tendinopathy.

    AB - UNLABELLED: Overuse is considered to be a main causative factor for tendinopathies; however, recent reports indicate that tendinopathy is also common among both overweight and inactive individuals. These factors are associated with abdominal obesity, dyslipidemia, hypertension, and insulin resistance. We hypothesized that these features would be associated with tendinopathy. PURPOSE: To compare lipid profile between participants with Achilles tendinopathy and matched controls. METHODS: Fasting serum lipids were measured among 60 participants with chronic painful midportion Achilles tendinopathy (54% male) and 60 control subjects matched for gender, age (+/-10 yr), and body mass index (+/-2 kg x m(-2)). RESULTS: The participants with Achilles tendinopathy showed evidence of underlying dyslipidemia. They had higher triglyceride (TG) levels (P = 0.039), lower %HDL-C (P = 0.016), higher TG/HDL-C ratio (P = 0.036), and elevated apolipoprotein B concentration (P = 0.017) in comparison to the well-matched control group. CONCLUSIONS: This pattern of dyslipidemia is characteristic of the dyslipidemia displayed by individuals with insulin resistance and is common in the metabolic syndrome. Two additional aspects of tendinopathy research support a connection with the metabolic syndrome. First, tendinopathy has been associated with greater waist circumference, as has the metabolic syndrome. Second, insulin resistance has been associated with fat deposition in muscle (primarily intracellular), whereas fat deposition in tendon has been found among those with tendon pain.If tendinopathy is confirmed to be associated with dyslipidemia and the metabolic syndrome in larger studies, it may be appropriate to redefine our concept of tendinopathy to that of a cardiovascular disease (CVD). In this case, we may be able to draw considerably on CVD research to improve our understanding of tendinopathy, and perhaps treating CVD risk factors will improve the treatment of tendinopathy.

    KW - Achilles Tendon

    KW - Adult

    KW - Blood Glucose

    KW - Body Mass Index

    KW - Case-Control Studies

    KW - Dyslipidemias

    KW - Fasting

    KW - Female

    KW - Humans

    KW - Insulin Resistance

    KW - Lipids

    KW - Male

    KW - Middle Aged

    KW - Risk Factors

    KW - Tendinopathy

    KW - Ultrasonography, Doppler

    KW - Comparative Study

    KW - Journal Article

    KW - Research Support, Non-U.S. Gov't

    U2 - 10.1249/MSS.0b013e31819794c3

    DO - 10.1249/MSS.0b013e31819794c3

    M3 - Article

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    SP - 1194

    EP - 1197

    JO - Medicine Science in Sports Exercise

    JF - Medicine Science in Sports Exercise

    SN - 0195-9131

    IS - 6

    ER -