title: Obesity as a risk factor for tendinopathy: a systematic review.
abstract: Purpose. In the last few years, evidence has emerged to support the possible association between increased BMI and susceptibility to some musculoskeletal diseases. We systematically review the literature to clarify whether obesity is a risk factor for the onset of tendinopathy. Methods. We searched PubMed, Cochrane Central, and Embase Biomedical databases using the keywords "obesity," "overweight," and "body mass index" linked in different combinations with the terms "tendinopathy," "tendinitis," "tendinosis," "rotator cuff," "epicondylitis," "wrist," "patellar," "quadriceps," "Achilles," "Plantar Fascia," and "tendon." Results. Fifteen studies were included. No level I study on this subject was available, and the results provided are ambiguous. However, all the 5 level II studies report the association between obesity measured in terms of BMI and tendon conditions, with OR ranging between 1.9 (95% CI: 1.1-2.2) and 5.6 (1.9-16.6). Conclusions. The best evidence available to date indicates that obesity is a risk factor for tendinopathy. Nevertheless, further studies should be performed to establish the real strength of the association for each type of tendinopathy, especially because the design of the published studies does not allow identifying a precise cause-effect relationship and the specific role of obesity independently of other metabolic conditions.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Trigoria, 00128 Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Franceschi
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Trigoria, 00128 Rome, Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: Papalia
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Trigoria, 00128 Rome, Italy.
authors.forename: Michele
authors.identifier: 0000-0001-5112-823X
authors.initials: M
authors.lastname: Paciotti
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Trigoria, 00128 Rome, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Franceschetti
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Trigoria, 00128 Rome, Italy.
authors.forename: Alberto
authors.identifier: 0000-0002-0716-4951
authors.initials: A
authors.lastname: Di Martino
authors.affiliation: Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Baronissi, 84081 Salerno, Italy ; Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London E1 4DG, UK.
authors.forename: Nicola
authors.identifier: 0000-0002-5327-3702
authors.initials: N
authors.lastname: Maffulli
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Trigoria, 00128 Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Denaro