Background/Purpose: Achilles tendinopathy is a painful debilitating injury that negatively affects physical activity, quality of life, and overall health. While exercise is considered the gold standard in the treatment of Achilles tendinopathy, many individuals continue to report symptoms and impairments in the short and long term. Advanced glycation end-products (AGEs) occur as a result of the reaction between glucose and protein (Couppé et al, 2017). Accumulation of AGEs, increased in those with hyperglycemia, has been related to altered tissue viscoelastic properties and may, in combination with other metabolic factors such as obesity, play a role in symptom severity and recovery from Achilles tendinopathy (Li et al, 2013; Abate et al, 2016). Therefore, the purpose of this study was to compare quantity of skin AGEs amongst identified subgroups of individuals with midportion Achilles tendinopathy.

Methods: Participants were categorized into four subgroups: Older activity-dominant (OAD), young activity-dominant (YAD), psychosocial-dominant (PD), and structure-dominant (SD) (Hanlon et al, 2021). AGEs were calculated using an AGE reader, a non-invasive device using skin autofluorescence to quantify AGEs in the skin. A one-way ANOVA was completed comparing AGEs and BMI among subgroups.

Results: 100 participants (mean±SD; 47.1±11.9; 49 female) with midportion Achilles tendinopathy were categorized as OAD (n=33), YAD (n=30), PD (n=24), SD (n=13). There was a significant main effect of group for AGEs (2.4±0.6, 1.9±0.4, 2.2±0.4, 2.4±0.4; p< .001). The SD group demonstrated significantly increased AGE compared to the YAD group (p=.003, p< .001) but no differences compared to the PD group or OAD group (p >.238). The OAD group demonstrated significantly increased AGE compared to the YAD group (p< .001). Additionally, there was a significant main effect of group for BMI (Table 1, p=.002) with the PD and SD groups demonstrating significantly greater BMI than the OAD and YAD groups. The PD and SD groups had mean BMI >30kg/cm² classifying these groups as obese.

Conclusion: Individuals in the Structure dominant and Older activity dominant subgroups present with higher AGEs compared to the Young activity-dominant subgroup. Additionally, the Structure dominant and Psychosocial dominant subgroups presented with BMI in the obesity range. Given the effects of AGEs and obesity on tendon health, addressing these measures in these subgroups may be needed to reduce symptom severity and improve recovery.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/differences-in-skin-advanced-glycation-end-products-levels-between-subgroups-of-achilles-tendinopathy/