Hyperglycemia Reduces Proteoglycan Levels in Tendons

Burner, Todd; Gohr, Claudia M.; Mitton-Fitzgerald, Elizabeth; Rosenthal, Ann K.

doi:10.3109/03008207.2012.710670

Cited by 44 publications

(37 citation statements)

References 36 publications

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“…A biological pathway exists whereby hyperglycaemia associated with diabetes affects collagen cross-linking in tendons7 and reduces proteoglycan content 58. One previous systematic review has investigated the association between diabetes and tendinopathy 59.…”

Section: Discussionmentioning

confidence: 99%

Is there an association between tendinopathy and diabetes mellitus? A systematic review with meta-analysis

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Is there an association between tendinopathy and diabetes mellitus? A systematic review with meta-analysis

et al. 2015

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Section: Impact On Soft Tissues Tendon Healingmentioning

confidence: 99%

“…An experimental pig model evaluating patellar tendons found that proteoglycan synthesis by tenocytes was reduced in tendons exposed to high concentrations of glucose [19] . Clinically, this may explain the high rate of tendon pathology seen in patients with DM [19] . A diabetic rat model of patellar tendon pathology has also demonstrated a decrease in Youngs modulus and high rate of intrasubstance failure [20] .…”

Section: Impact On Soft Tissues Tendon Healingmentioning

confidence: 99%

Diabetes and its negative impact on outcomes in orthopaedic surgery

Wukich

2015

WJO

110

103

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An estimated 285 million adults (aged 20-79 years) worldwide were diagnosed to have diabetes mellitus (DM) in 2010, and this number is projected to grow to 439 million adults by the year 2030. Orthopaedic surgeons, regardless of their subspecialty interest, will encounter patients with DM during their career since this epidemic involves both developed and emerging countries. Diabetes results in complications affecting multiple organ systems, potentially resulting in adverse outcomes after orthopaedic surgery. The purpose of this review is to discuss the pathophysiology of DM and its potential for impacting orthopaedic surgery patients. Diabetes adversely affects the outcome of all orthopaedic surgery subspecialties including foot and ankle, upper extremity, adult reconstructive, pediatrics, spine surgery and sports medicine. Poorly controlled diabetes negatively impacts bone, soft tissue, ligament and tendon healing. It is the complications of diabetes such as neuropathy, peripheral artery disease, and end stage renal disease which contributes to adverse outcomes. Well controlled diabetic patients without comorbidities have similar outcomes to patients without diabetes. Orthopaedic surgeons should utilize consultants who will assist in inpatient glycemic management as well as optimizing long term glycemic control.

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“…It has also been shown that the hyperglycemia could reduce proteoglycan levels in the tendon cells in high glucose condition exposure to AGEs. Decreased proteoglycan levels could increase intracellular water and cellular edema, and these alterations may lead to the increased stiffness in diabetic tendons [36].…”

Section: Biomechanical Changesmentioning

confidence: 99%

“…AGEs interact with RAGE on the cell surface and activate several critical molecular pathways including pro-oxidant events and up-regulation of inflammatory mediators; the intracellular accumulation of AGEs could lead to negative effects, such as inhibiting cell growth, destruction of nitric oxide and promoting apoptosis [52][53][54]. AGEs is also involved in the scar formation and cause of tendon cell death [36]. The tendon cells treated with high glucose concentrations showed the decreased proteoglycans and increased transforming growth factor β1 (TGF-β1) levels in an AGEindependent manner, and high TGF-β levels is reported to associate with scar formation in tendon and tenocyte death [55].…”

Section: Agesmentioning

confidence: 99%

Alterations of tendons in diabetes mellitus: what are the current findings?

Shi

Menemenlis

et al. 2015

International Orthopaedics (SICOT)

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As a connective tissue, tendon connects the muscle and bone, and plays the key role in the locomotor system. Some previous studies have shown the pathological alternations in diabetic tendons, which might result in the structural and functional changes, and even accelerate the process of diabetic foot. In this review, we examined the current findings of the diabetic tendons in the form of various aspects, and summarized the clinical presentation, imaging, biomechanical, histopathological, cellular and molecular abnormalities in the diabetic tendons. The progress of diabetic tendon damage is complicated and the main hypotheses include the excessive accumulation of AGEs, the altered inflammatory response, neovascularization and insensitive neuropathy. However, the cellular and molecular mechanisms of these alterations are still ambiguous. Tendon stem/progenitor cells (TSPCs) have been discovered to play important roles in both tendon physiology and tendon pathology. Recently, we identified TSPCs from patellar tendons in our well-established diabetic rat model and found impaired tenogenic differentiation potential of these cells. We proposed a new hypothesis that the impaired cell functions of diabetic TSPCs might be the underlying cellular and molecular mechanism of the diabetic tendon alternations. These findings should be helpful to establish a better therapeutic strategy for diabetic tendon repair and regeneration.

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Hyperglycemia Reduces Proteoglycan Levels in Tendons

Abstract: Hyperglycemia produces a reduction in PG levels related to decreased synthesis or sulfation of glycosaminoglycans, which may contribute to the tendon pathology observed clinically in diabetes.

Cited by 44 publications

References 36 publications

Is there an association between tendinopathy and diabetes mellitus? A systematic review with meta-analysis

Is there an association between tendinopathy and diabetes mellitus? A systematic review with meta-analysis

Diabetes and its negative impact on outcomes in orthopaedic surgery

Alterations of tendons in diabetes mellitus: what are the current findings?

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