Jewson J L, Lambert E A, Docking S, Storr M, Lambert G W, Gaida J E
Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia.
Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Vic., Australia.
Scand J Med Sci Sports. 2017 Dec;27(12):1942-1949. doi: 10.1111/sms.12820. Epub 2016 Dec 28.
Tendinopathy is a common condition, which has been linked to surrogate measures of sympathetic nervous system (SNS) activity and insulin resistance. This study aimed to compare in vivo measures of the SNS and insulin resistance between individuals with and without Achilles tendinopathy. This case-control study compared Achilles tendinopathy sufferers to healthy controls. SNS activity was quantified using muscle sympathetic nerve activity (MSNA), while metabolic status was assessed via a modified glucose tolerance test and fasting lipid panel. Ultrasound tissue characterization assessed tendon structure. Resting MSNA did not differ between the 15 cases and 20 controls. Tendon pain duration in tendinopathy patients was correlated with burst frequency (R =.32, P=.02) and burst incidence (R =.41, P=.01) of MSNA. After adjusting for multiple comparisons, there was a trend suggesting fasting glucose was greater in cases (median 4.80, IQR .70 in cases vs 4.51, .38 in controls) and correlated with pain severity (R =.14, P=.03), but no other metabolic measures were associated with tendon pain/structure. This study indicates that SNS activity is associated with tendon pain duration, building on previous data indicating the SNS is involved in recalcitrant tendinopathy. Metabolic parameters had little relationship with Achilles tendinopathy in this metabolically homogenous sample. Prospective studies are required to uncover the precise relationship between SNS activity, insulin resistance, and tendinopathy.
肌腱病是一种常见病症，它与交感神经系统（SNS）活动及胰岛素抵抗的替代指标有关。本研究旨在比较有和没有跟腱肌腱病的个体之间SNS和胰岛素抵抗的体内测量值。这项病例对照研究将跟腱肌腱病患者与健康对照者进行了比较。使用肌肉交感神经活动（MSNA）对SNS活动进行量化，同时通过改良葡萄糖耐量试验和空腹血脂检查评估代谢状态。超声组织特征分析评估肌腱结构。15例患者和20例对照者的静息MSNA无差异。肌腱病患者的肌腱疼痛持续时间与MSNA的爆发频率（R = 0.32，P = 0.02）和爆发发生率（R = 0.41，P = 0.01）相关。在对多重比较进行校正后，有一个趋势表明病例组的空腹血糖更高（病例组中位数为4.80，四分位距为0.70；对照组为4.51，四分位距为0.38），且与疼痛严重程度相关（R = 0.14，P = 0.03），但没有其他代谢指标与肌腱疼痛/结构相关。本研究表明，基于先前表明SNS参与顽固性肌腱病的数据，SNS活动与肌腱疼痛持续时间有关。在这个代谢同质的样本中，代谢参数与跟腱肌腱病关系不大。需要进行前瞻性研究以揭示SNS活动、胰岛素抵抗和肌腱病之间的确切关系。
