title: Occurrence of tendon pathologies in metabolic disorders.
abstract: This article reviews the pathogenetic role of metabolic disorders, which are of paramount relevance to the progression of tendon damage. In diabetes, the prevalence of rheumatological diseases is high, mainly because of the deleterious effects of advanced glycation end products that deteriorate the biological and mechanical functions of tendons and ligaments. In heterozygous familial hypercholesterolaemia, most patients develop Achilles xanthomatosis, a marker of high risk for cardiovascular disease caused by cholesterol deposition in the tendons. Tendon degeneration has also been observed in non-familial hypercholesterolaemia. Monosodium urate crystal deposition in soft tissues is a hallmark of chronic gouty arthritis. In this group of diseases, the mobilization of cholesterol and uric acid crystals is presumably followed by low-grade inflammation, which is responsible for tendon degeneration. Adiposity may contribute to tendon disorders via two different mechanisms: increased weight on the load-bearing tendons and systemic dysmetabolic factors that trigger subclinical persistent inflammation. Finally, tendon abnormalities have been observed in some rare congenital metabolism disorders such as alkaptonuria.
authors: Department of Medicine and Science of Aging, University G. d'Annunzio, Chieti-Pescara, Chieti Scalo (CH), Italy. m.abate@unich.it
authors: Michele
authors: M
authors: Abate
authors: Cosima
authors: C
authors: Schiavone
authors: Vincenzo
authors: V
authors: Salini
authors: Isabel
authors: I
authors: Andia
mesh_terms: D048909:Diabetes Complications; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications; D033461:Hyperuricemia / Q000150:complications; D008659:Metabolic Diseases / Q000150:complications*; D052256:Tendinopathy / Q000209:etiology*