The effect of hypercholesterolemia on rotator cuff disease.
BACKGROUND
The causes of rotator cuff tendon rupture are multifactorial and still unclear. Intrinsic and extrinsic factors have been implicated as predisposing risk factors for rotator cuff rupture. Previous studies have suggested a relationship between elevated serum lipid profiles and tendon ruptures, although not rotator cuff tears specifically.


OBJECTIVE
We therefore asked whether patients with rotator cuff tears were more likely to have higher levels of hypercholesterolemia than patients with shoulder pain but without tears.


METHODS
We prospectively collected serum cholesterol and lipid profiles on two age-matched populations of patients; 74 (mean age, 66.3 years) had ruptures of their rotator cuff tendons, whereas a control group of 73 patients (mean age, 67.4 years) were seen for nontendon-related shoulder complaints.


RESULTS
Total cholesterol, triglycerides, and low-density lipoprotein cholesterol concentrations of the patients with rotator cuff tendon tears were higher, and their high-density lipoprotein cholesterol showed a trend to being lower than the control group. Forty-seven of 74 patients (63%) with rotator cuff tears had an elevated serum cholesterol (total cholesterol greater than 240 mg/dL) as compared with an overall rate of 28% in our control group.


CONCLUSIONS
Patients with rotator cuff tears were more likely to have hypercholesterolemia when compared with the control group.


CONCLUSIONS
Measurement of serum cholesterol in patients presenting with torn rotator cuff tendons should be considered in patients whose cholesterol profiles are unknown. Future consideration of drug treatment may reduce risk for future tendon degeneration, as well as improve quality of life and reduce mortality.


METHODS
Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Abboud
Joseph A
JA
University of Pennsylvania Health System, 3B Orthopaedics, Pennsylvania Hospital, 800 Spruce Street, 8th Floor Preston, Philadelphia, PA 19107, USA. Joseph.Abboud@uphs.upenn.edu
Kim
Jae S
JS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D015994:Incidence; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D000070636:Rotator Cuff Injuries; D012421:Rupture; D013708:Tendon Injuries / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
D015415:Biomarkers; D008078:Cholesterol, LDL; D008055:Lipids; D014280:Triglycerides; D002784:Cholesterol