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Does glucocorticoid exposure explain the association between metabolic dysfunction and tendinopathy?
Trevor Lewis1, Eva Zeisig2, James Gaida3
1T Lewis, Aintree University Hospitals NHS Foundation Trust, Liverpool, United Kingdom of Great Britain and Northern Ireland.
Endocrine Connections
|January 23, 2020
Summary
Glucocorticoid excess, linked to metabolic issues like insulin resistance and type 2 diabetes, may explain how poor metabolic health leads to tendinopathy and tendon rupture.
Area of Science:
- Endocrinology
- Orthopedics
- Metabolic Health
Background:
- Metabolic health influences connective tissue, but mechanisms are unclear.
- Glucocorticoids regulate key physiological processes and their excess causes metabolic dysfunction.
- Metabolic states like insulin resistance are linked to tendinopathy.
Purpose of the Study:
- To synthesize current knowledge on glucocorticoid exposure and tendon health.
- To explore the link between glucocorticoids, metabolic health, and tendinopathy.
Main Methods:
- Narrative literature review.
- Overview of glucocorticoid production, regulation, and signaling.
- Review of oral and injected glucocorticoid effects on tendons.
Main Results:
- Glucocorticoid excess is associated with visceral adiposity, dyslipidemia, insulin resistance, and type 2 diabetes.
- Clinical and mechanistic overlaps exist between tendinopathy and glucocorticoid excess.
- Glucocorticoids may underpin the connection between metabolic health and tendon dysfunction.
Conclusions:
- Glucocorticoids may mediate the link between metabolic health and tendinopathy.
- Several plausible pathways connect glucocorticoid action to tendon issues.
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