The effects of cholesterol accumulation on Achilles tendon biomechanics: A cross-sectional study.

Familial hypercholesterolemia, a common genetic metabolic disorder characterized by high cholesterol levels, is involved in the development of atherosclerosis and other preventable diseases. Familial hypercholesterolemia can also cause tendinous abnormalities, such as thickening and xanthoma (tendon...

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Autores principales:	Kipling Squier, Alexander Scott, Michael A Hunt, Liam R Brunham, David R Wilson, Hazel Screen, Charlie M Waugh
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/dd44df6166894730b03764e8a997f5c7
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spelling	oai:doaj.org-article:dd44df6166894730b03764e8a997f5c72021-12-02T20:06:14ZThe effects of cholesterol accumulation on Achilles tendon biomechanics: A cross-sectional study.1932-620310.1371/journal.pone.0257269https://doaj.org/article/dd44df6166894730b03764e8a997f5c72021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0257269https://doaj.org/toc/1932-6203Familial hypercholesterolemia, a common genetic metabolic disorder characterized by high cholesterol levels, is involved in the development of atherosclerosis and other preventable diseases. Familial hypercholesterolemia can also cause tendinous abnormalities, such as thickening and xanthoma (tendon lipid accumulation) in the Achilles, which may impede tendon biomechanics. The objective of this study was to investigate the effect of cholesterol accumulation on the biomechanical performance of Achilles tendons, in vivo. 16 participants (10 men, 6 women; 37±6 years) with familial hypercholesterolemia, diagnosed with tendon xanthoma, and 16 controls (10 men, 6 women; 36±7 years) underwent Achilles biomechanical assessment. Achilles biomechanical data was obtained during preferred pace, shod, walking by analysis of lower limb kinematics and kinetics utilizing 3D motion capture and an instrumented treadmill. Gastrocnemius medialis muscle-tendon junction displacement was imaged using ultrasonography. Achilles stiffness, hysteresis, strain and force were calculated from displacement-force data acquired during loading cycles, and tested for statistical differences using one-way ANOVA. Statistical parametric mapping was used to examine group differences in temporal data. Participants with familial hypercholesterolemia displayed lower Achilles stiffness compared to the control group (familial hypercholesterolemia group: 87±20 N/mm; controls: 111±18 N/mm; p = 0.001), which appeared to be linked to Achilles loading rate rather than an increased strain (FH: 5.27±1.2%; controls: 4.95±0.9%; p = 0.413). We found different Achilles loading patterns in the familial hypercholesterolemia group, which were traced to differences in the centre of pressure progression that affected ankle moment. This finding may indicate that individuals with familial hypercholesterolemia use different Achilles loading strategies. Participants with familial hypercholesterolemia also demonstrated significantly greater Achilles hysteresis than the control group (familial hypercholesterolemia: 57.5±7.3%; controls: 43.8±10%; p<0.001), suggesting that walking may require a greater metabolic cost. Our results indicate that cholesterol accumulation could contribute to reduced Achilles function, while potentially increasing the chance of injury.Kipling SquierAlexander ScottMichael A HuntLiam R BrunhamDavid R WilsonHazel ScreenCharlie M WaughPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0257269 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kipling Squier Alexander Scott Michael A Hunt Liam R Brunham David R Wilson Hazel Screen Charlie M Waugh The effects of cholesterol accumulation on Achilles tendon biomechanics: A cross-sectional study.
description	Familial hypercholesterolemia, a common genetic metabolic disorder characterized by high cholesterol levels, is involved in the development of atherosclerosis and other preventable diseases. Familial hypercholesterolemia can also cause tendinous abnormalities, such as thickening and xanthoma (tendon lipid accumulation) in the Achilles, which may impede tendon biomechanics. The objective of this study was to investigate the effect of cholesterol accumulation on the biomechanical performance of Achilles tendons, in vivo. 16 participants (10 men, 6 women; 37±6 years) with familial hypercholesterolemia, diagnosed with tendon xanthoma, and 16 controls (10 men, 6 women; 36±7 years) underwent Achilles biomechanical assessment. Achilles biomechanical data was obtained during preferred pace, shod, walking by analysis of lower limb kinematics and kinetics utilizing 3D motion capture and an instrumented treadmill. Gastrocnemius medialis muscle-tendon junction displacement was imaged using ultrasonography. Achilles stiffness, hysteresis, strain and force were calculated from displacement-force data acquired during loading cycles, and tested for statistical differences using one-way ANOVA. Statistical parametric mapping was used to examine group differences in temporal data. Participants with familial hypercholesterolemia displayed lower Achilles stiffness compared to the control group (familial hypercholesterolemia group: 87±20 N/mm; controls: 111±18 N/mm; p = 0.001), which appeared to be linked to Achilles loading rate rather than an increased strain (FH: 5.27±1.2%; controls: 4.95±0.9%; p = 0.413). We found different Achilles loading patterns in the familial hypercholesterolemia group, which were traced to differences in the centre of pressure progression that affected ankle moment. This finding may indicate that individuals with familial hypercholesterolemia use different Achilles loading strategies. Participants with familial hypercholesterolemia also demonstrated significantly greater Achilles hysteresis than the control group (familial hypercholesterolemia: 57.5±7.3%; controls: 43.8±10%; p<0.001), suggesting that walking may require a greater metabolic cost. Our results indicate that cholesterol accumulation could contribute to reduced Achilles function, while potentially increasing the chance of injury.
format	article
author	Kipling Squier Alexander Scott Michael A Hunt Liam R Brunham David R Wilson Hazel Screen Charlie M Waugh
author_facet	Kipling Squier Alexander Scott Michael A Hunt Liam R Brunham David R Wilson Hazel Screen Charlie M Waugh
author_sort	Kipling Squier
title	The effects of cholesterol accumulation on Achilles tendon biomechanics: A cross-sectional study.
title_short	The effects of cholesterol accumulation on Achilles tendon biomechanics: A cross-sectional study.
title_full	The effects of cholesterol accumulation on Achilles tendon biomechanics: A cross-sectional study.
title_fullStr	The effects of cholesterol accumulation on Achilles tendon biomechanics: A cross-sectional study.
title_full_unstemmed	The effects of cholesterol accumulation on Achilles tendon biomechanics: A cross-sectional study.
title_sort	effects of cholesterol accumulation on achilles tendon biomechanics: a cross-sectional study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/dd44df6166894730b03764e8a997f5c7
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The effects of cholesterol accumulation on Achilles tendon biomechanics: A cross-sectional study.

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