Tendon Pathology in Hypercholesterolemia and Familial Hypercholesterolemia

Abstract

Purpose of review: Hypercholesterolemia (HC), or high cholesterol, is usually caused by diet, other health conditions, or inherited diseases, such as familial hypercholesterolemia (FHC). Studies have shown patients with hypercholesterolemia are more prone to tendon injury and impaired healing. Nonetheless, the mechanism by which high cholesterol alters the biochemical and biomechanical properties of tendon and the healing environment is not well defined. This review highlights scientific findings on the relationship between hypercholesterolemia and treatments and tendon pathology at the cellular and tissue level.

Recent findings: The release of pro-inflammatory cytokines and upregulation of matrix-degrading proteins in hypercholesterolemic conditions leads to an increase in tendon stiffness and elastic modulus. The effect of hypercholesterolemia drugs, such as statins, on tendon pathology remains unclear. More insight into the relationship between HC and tendon pathology can lead to improved imaging modalities and therapeutics for tendinopathy in hypercholesterolemic patients.

Keywords: Familial hypercholesterolemia; Hypercholesterolemia; Statins; Tendon pathology; xanthomas.