Evidence map›Paper›PMID 34921194›Full record

ArticleScientific reports2021

Human Achilles tendon mechanical behavior is more strongly related to collagen disorganization than advanced glycation end-products content.

Jennifer A Zellers, Jeremy D Eekhoff, Remy E Walk, Mary K Hastings, Simon Y Tang, Spencer P Lake

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02616263 (Muscle, Joint and Movement Deterioration Contributing to Neuropathic Forefoot Deformity), which is not on this map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02616263 nacompletednot on this map

Muscle, Joint and Movement Deterioration Contributing to Neuropathic Forefoot Deformity

TypeinterventionalSponsorWashington University School of MedicineRan2016 to 2021Enrolled60ConditionsDiabetes Mellitus (DM)ArmsFoot exercise, Shoulder exercise
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 20 citations in OpenAlex.

  1. Review
  2. Review
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  9. Metabolic Risk Factors Relate to Worse Tendon Health in Individuals With Achilles Tendinopathy.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2025
    Article
  10. Review
  11. Review
  12. Article
  13. Article
  14. Review
  15. Advanced-Glycation Endproducts: How cross-linking properties affect the collagen fibril behavior.Journal of the mechanical behavior of biomedical materials · 2023
    Article
  16. Quantative MRI predicts tendon mechanical behavior, collagen composition, and organization.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2023
    Article
  17. Article
  18. The influence of AGEs and enzymatic cross-links on the mechanical properties of collagen fibrils.Journal of the mechanical behavior of biomedical materials · 2023
    Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 2 countries.

Jennifer A ZellersProgram in Physical Therapy, Washington University School of Medicine in St. Louis, 4444 Forest Park Ave, St. Louis, MO, 63108, USA. jzellers@wustl.edu.
Jeremy D EekhoffDepartment of Biomedical Engineering, Washington University in St. Louis, 1 Brookings Drive, St. Louis, MO, 63130, USA.
Remy E WalkDepartment of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, 425 S. Euclid Ave, St. Louis, MO, 63110, USA.
Mary K HastingsProgram in Physical Therapy, Washington University School of Medicine in St. Louis, 4444 Forest Park Ave, St. Louis, MO, 63108, USA.
Simon Y TangDepartment of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, 425 S. Euclid Ave, St. Louis, MO, 63110, USA.
Spencer P LakeDepartment of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, 425 S. Euclid Ave, St. Louis, MO, 63110, USA.
Washington University in St. Louis · US

Funding

Resource Based Center for Musculoskeletal Biology and Medicine (Overall Application)P30AR074992 · NIAMS · WASHINGTON UNIVERSITY · PI DEBORAH J VEIS · 2019 to 2026
$6.8M
Skeletal Disorders Training ProgramT32AR060719 · NIAMS · WASHINGTON UNIVERSITY · PI Roberto Civitelli · 2011 to 2026
$4.6M
MUSCLE, JOINT AND MOVEMENT DETERIORATION CONTRIBUTING TO NEUROPATHIC FOREFOOT DEFORMITYR01DK107809 · NIDDK · WASHINGTON UNIVERSITY · PI MARY K HASTINGS · 2016 to 2026
$4.3M
DOCTORAL TRAINING PROGRAM IN MOVEMENT SCIENCET32HD007434 · NICHD · WASHINGTON UNIVERSITY · PI Michael D Harris, Catherine Lang · 1993 to 2026
$4.2M
The role of physiologic and pathologic AGEs on RAGE signaling in IVD degenerationR01AR074441 · NIAMS · WASHINGTON UNIVERSITY · PI TANG, SIMON YUE-CHEONG · 2019 to 2024
$2.1M
Diabetes-related Tendon Changes: Integrating Ex Vivo and In Vivo ApproachesF32DK123916 · NIDDK · WASHINGTON UNIVERSITY · PI ZELLERS, JENNIFER · 2019 to 2020
$127k
NIAMS NIH HHS P30 AR074992NIAMS NIH HHS R01 AR074441NIAMS NIH HHS T32 AR060719NICHD NIH HHS T32 HD007434NIDDK NIH HHS F32 DK123916NIDDK NIH HHS R01 DK107809
6 · The paper itself

Abstract

Diabetes is associated with impaired tendon homeostasis and subsequent tendon dysfunction, but the mechanisms underlying these associations is unclear. Advanced glycation end-products (AGEs) accumulate with diabetes and have been suggested to alter tendon function. In vivo imaging in humans has suggested collagen disorganization is more frequent in individuals with diabetes, which could also impair tendon mechanical function. The purpose of this study was to examine relationships between tendon tensile mechanics in human Achilles tendon with accumulation of advanced glycation end-products and collagen disorganization. Achilles tendon specimens (n = 16) were collected from individuals undergoing lower extremity amputation or from autopsy. Tendons were tensile tested with simultaneous quantitative polarized light imaging to assess collagen organization, after which AGEs content was assessed using a fluorescence assay. Moderate to strong relationships were observed between measures of collagen organization and tendon tensile mechanics (range of correlation coefficients: 0.570-0.727), whereas no statistically significant relationships were observed between AGEs content and mechanical parameters (range of correlation coefficients: 0.020-0.210). Results suggest that the relationship between AGEs content and tendon tensile mechanics may be masked by multifactorial collagen disorganization at larger length scales (i.e., the fascicle level).

Indexed as

Stress, MechanicalAchilles TendonCollagenDiabetes MellitusFemaleGlycation End Products, AdvancedHumansMaleMiddle AgedCollagenGlycation End Products, Advanced

Identifiers

PMID34921194
PMCPMC8683434
OpenAlexW4200293208

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.