Association between Increased Age at Anterior Cruciate Ligament Reconstruction and Metabolic Syndrome

Metabolic syndrome (MetSy) is a global pandemic characterized by a cluster of interrelated abnormalities and risk factors. The prevalence of MetSy increases with advancing age. It is unknown whether increased age at the time of anterior cruciate ligament reconstruction (ACLR) is associated with an increased prevalence of MetSy.

To identify the association of age at ACLR with MetSy.

Cohort study; Level of evidence, 3.

Patients aged ≥18 years who underwent ACLR, with available blood pressure, blood lipids, hemoglobin A1c (HbA1c), and basic descriptive data, were included. All data were extracted from the medical records at a single academic institution. MetSy was defined as meeting any 3 of the following 5 criteria: (1) body mass index (BMI) ≥30 kg/m²; (2) triglycerides ≥150 mg/dL; (3) high-density lipoprotein (HDL) <40 mg/dL in men and <50 mg/dL in women; (4) systolic blood pressure of ≥130 mmHg or diastolic blood pressure of ≥85 mmHg; or (5) fasting (estimated) glucose of ≥100 mg/dL. Patients were also separated into groups based on age at the time of ACLR: (1) 18-29, (2) 30-39, (3) 40-49, and (4) ≥50 years.

The final analysis consisted of 493 patients (age, 18-29 years [n = 139]; 30-39 years [n = 158]; 40-49 years [n = 135]; and ≥50 years [n = 61]). Based on the criteria, 190 (38.5%) patients who underwent ACLR displayed MetSy. The prevalence of MetSy was not significantly different between age groups (P = .70). The proportion of patients meeting the individual BMI (P = .41), triglyceride (P = .05), HDL (P = .41), and blood pressure (P = .82) criteria of MetSy was not significantly different between age groups. In contrast, approximately 59% (n = 82) of patients in the 18-29 years age group compared with 88.5% (n = 54) in the ≥50 years age group had an estimated fasting glucose of ≥100 mg/dL (P < .01). HbA1c% was also significantly increased in the ≥50 years age group compared with the younger age groups (P < .01).

Increased age at ACLR was not associated with MetSy but may be associated with an elevated HbA1c and estimated fasting glucose.