title: Lipids, adiposity and tendinopathy: is there a mechanistic link? Critical review.
abstract: Being overweight or obese is associated with an elevated risk of tendon pathology. However, for sportspeople the epidemiological data linking weight or adiposity on one hand, and risk of tendon pathology on the other, are less consistent. Indeed, the mechanistic links between diet, adiposity and tendon pathology remain largely unexamined. Recent studies have begun to examine the effects of dietary interventions on outcomes such as tendon biomechanics or pain. Oxidised low-density lipoprotein has been shown to (A) accumulate in the tendon tissues of mice that eat a fatty diet and (B) induce a pathological phenotype in human tendon cells. This paper addresses the current debate: is excessive body mass index (causing increased load and strain on tendon tissue) per se the underlying mechanism? Or do local or systemic influences of fat on tendons predispose to tendon pathology? This narrative review argues that excessive blood lipids may be an important avenue for clinical investigations.
authors.affiliation: Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada Vancouver Coastal Health Research Institute, Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada.
authors.forename: Alex
authors.initials: A
authors.lastname: Scott
authors.affiliation: University of Groningen, University Medical Center Groningen, Center for Sports Medicine, Groningen, The Netherlands.
authors.forename: Johannes
authors.initials: J
authors.lastname: Zwerver
authors.affiliation: Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada Vancouver Coastal Health Research Institute, Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada.
authors.forename: Navi
authors.initials: N
authors.lastname: Grewal
authors.affiliation: Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada Vancouver Coastal Health Research Institute, Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada.
authors.forename: Agnetha
authors.initials: A
authors.lastname: de Sa
authors.affiliation: Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada Vancouver Coastal Health Research Institute, Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada.
authors.forename: Thuraya
authors.initials: T
authors.lastname: Alktebi
authors.affiliation: UBC James Hogg Research Centre, Institute for Heart + Lung Health, St. Paul's Hospital, University of British Columbia, Vancouver, Canada.
authors.forename: David J
authors.initials: DJ
authors.lastname: Granville
authors.affiliation: University of Calgary, McCaig Institute for Bone and Joint Health, Calgary, Alberta, Canada.
authors.forename: David A
authors.initials: DA
authors.lastname: Hart
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena / Q000502:physiology; D001786:Blood Glucose / Q000502:physiology; D004032:Diet; D004812:Epidemiologic Methods; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006949:Hyperlipidemias / Q000150:complications / Q000188:drug therapy; D008055:Lipids / Q000502:physiology*; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D012421:Rupture / Q000209:etiology; D057185:Sedentary Behavior; D013177:Sports / Q000502:physiology; D052256:Tendinopathy / Q000209:etiology*
chemical_list: D001786:Blood Glucose; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids
keywords: Body composition; Fat; Injury; Overuse; Tendon