ArticlePloS one2018
Achilles tendon structure is negatively correlated with body mass index, but not influenced by statin use: A cross-sectional study using ultrasound tissue characterization.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 31 citations in OpenAlex.
- Understanding the impact of Achilles lipid content on tendon mechanical parameters: a cross-sectional study of people with familial hypercholesterolemia and healthy controls.BMC musculoskeletal disorders · 2025Article
- Ultrasound tissue characterization and function of Achilles tendon in psoriatic arthritis patients: a cross-sectional study.European journal of physical and rehabilitation medicine · 2025Article
- Comparison of diagnostic image modalities for the detection of Achilles tendon tendinopathy using ankle magnetic resonance imaging.Frontiers in physiology · 2025Article
- The Association of Body Mass Index and Waist Circumference with the Risk of Achilles Tendon Problems: A Nationwide Population-Based Longitudinal Cohort Study.Clinics in orthopedic surgery · 2023Article
- Exposure to oxLDL impairs TGF-β activity in human tendon cells.BMC musculoskeletal disorders · 2023Article
- HDL Cholesterol Efflux and Serum Cholesterol Loading Capacity Alterations Associate to Macrophage Cholesterol Accumulation in FH Patients with Achilles Tendon Xanthoma.International journal of molecular sciences · 2022Article
- Creating an Optimal In Vivo Environment to Enhance Outcomes Using Cell Therapy to Repair/Regenerate Injured Tissues of the Musculoskeletal System.Biomedicines · 2022Review
- Optimizing repair of tendon ruptures and chronic tendinopathies: Integrating the use of biomarkers with biological interventions to improve patient outcomes and clinical trial design.Frontiers in sports and active living · 2022Review
- The Impact of the Degree of Kinesiophobia on Recovery in Patients With Achilles Tendinopathy.Physical therapy · 2021Observational
- Dyslipidemia Is Associated With Increased Risk of Achilles Tendon Disorders in Underweight Individuals to a Greater Extent Than Obese Individuals: A Nationwide, Population-Based, Longitudinal Cohort Study.Orthopaedic journal of sports medicine · 2021Article
- The combined effects of obesity and ageing on skeletal muscle function and tendon properties in vivo in men.Endocrine · 2021Article
- Tensile mechanical changes in the Achilles tendon due to Insertional Achilles tendinopathy.Journal of the mechanical behavior of biomedical materials · 2020Article
- The influence of a multidisciplinary intervention program on Achilles tendon structure in children with overweight and obesity.European journal of pediatrics · 2020Article
- Running a Marathon-Its Influence on Achilles Tendon Structure.Journal of athletic training · 2020Article
- Transverse tendon stiffness is reduced in people with Achilles tendinopathy: A cross-sectional study.PloS one · 2019Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionStatins are widely used to inhibit cholesterol production in the liver among people with hypercholesterolemia. A recent epidemiological study in the UK has shown that statin use (unlike elevated BMI) is not associated with an increased risk of Achilles tendon rupture. However, because of laboratory reports suggesting a negative influence of statins on tenocyte metabolism, we decided to directly compare the Achilles tendon structure (cross-sectional area and longitudinal collagen organization) in regular statin users compared to non-users.
methodsWe conducted ultrasound tissue characterization (UTC) of the Achilles tendon in statin users and a comparison group of similar age and gender. Statin users and control participants were recruited from May 10 2015 to February 17 2017 through a cardiovascular health centre and from the general community. Cross-sectional area of the Achilles tendon and longitudinal collagen organization (% type I echoes) were assessed using quantitative ultrasound tissue characterization by a blinded observer at a predetermined location (2 cm proximal to the calcaneus).
resultsSixty-six individuals who were either taking statins for at least one year (ST, n = 33) or a comparison group who had never taken statins (CG, n = 33) were included in the study. The Achilles tendon cross-sectional area (ST 59.7 (13) mm2, CG 59.9 (8.5) mm2) and proportion of echo-type I patterns [ST 70 (10)%, CG 74 (13)%] were equivalent in the two groups. In contrast, there was a negative correlation between BMI (rs = -0.25, p = 0.042) and type I echo values. Obese individuals demonstrated a significantly lower percentage of type I echoes (62 (11)%) than individuals of normal body mass index (73 (10)% p<0.05).
conclusionThese findings demonstrate that there is no evidence of a negative statin influence on Achilles tendon structure. Given earlier reports that the risk of Achilles injury is equivalent in statin users and non-users, weightbearing exercise may be prescribed without placing the Achilles tendon at a higher risk of injury than among the general population. The results of this study are consistent with the known negative effects of elevated BMI on tendon structure, suggesting that an assessment of the Achilles tendons prior to prescribing weightbearing exercise may be prudent in obese individuals.
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