Statins and muscles: what price glory?

Independent Risk Factors Predicting Gradual Onset Injury in 2824 Trail Running Race Entrants: SAFER XVIII Study

INTRODUCTION

Trail running is characterized by elevation changes, with uneven and varying running surfaces. Risk factors that may predict gradual-onset running-related injuries (GORRIs) in short-distance trail running have not been explored. The objective was to determine risk factors that predict GORRIs in trail running race entrants who entered mass community-based trail running events.

METHODS

In this descriptive cross-sectional study, data were collected prospectively from a prerace medical screening questionnaire over 4 trail run events held annually. Using a Poisson regression model, runner demographics, race distance, running training/racing variables, history of chronic diseases (number of chronic diseases reported as a cumulative "chronic disease composite score"), and allergies were investigated to determine factors predicting self-reported GORRI history in the previous 12 mo.

RESULTS

This study included 2824 race entrants (80% of entrants). The retrospective annual incidence for GORRIs was 13%. Independent risk factors predicting GORRIs were longer race distance (P<0.0001), increasing chronic disease composite score (P=0.0012), and a history of allergies (P=0.0056). The lower limb (94%) was the main anatomic region of GORRIs, and soft tissue injuries accounted for most (83%) GORRIs. Common specific GORRIs were iliotibial band syndrome (22%), Achilles tendon injury (10%), and hamstring injury (9%).

CONCLUSIONS

Independent risk factors predicting GORRIs among trail running entrants included longer race distance, a higher chronic disease composite score, and a history of allergies. This study has highlighted trail running race entrants at risk for sustaining GORRIs who could be targeted for future injury prevention interventions.

Exploring the In Vivo Anti-Inflammatory Actions of Simvastatin-Loaded Porous Microspheres on Inflamed Tenocytes in a Collagenase-Induced Animal Model of Achilles Tendinitis

Tendon rupture induces an inflammatory response characterized by release of pro-inflammatory cytokines and impaired tendon performance. This study sought to investigate the therapeutic effects of simvastatin-loaded porous microspheres (SIM/PMSs) on inflamed tenocytes in vitro and collagenase-induced Achilles tendinitis in vivo. The treatment of SIM/PMSs in lipopolysaccharide (LPS)-treated tenocytes reduced the mRNA expressions of pro-inflammatory cytokines (Matrix metalloproteinase-3 (MMP-3), cyclooxygenase-2 (COX-2), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α)). In addition, the local injection of SIM/PMSs into the tendons of collagenase-induced Achilles tendinitis rat models suppressed pro-inflammatory cytokines (MMP-3, COX-2, IL-6, TNF-α, and MMP-13). This local treatment also upregulated anti-inflammatory cytokines (IL-4, IL-10, and IL-13). Furthermore, treatment with SIM/PMSs also improved the alignment of collagen fibrils and effectively prevented collagen disruption in a dose-dependent manner. Therefore, SIM/PMSs treatment resulted in an incremental increase in the collagen content, stiffness, and tensile strength in tendons. This study suggests that SIM/PMSs have great potential for tendon healing and restoration in Achilles tendinitis.

Statins in rheumatology

Statins were developed for the treatment of lipid disorders and have been proved to reduce cardiovascular morbidity and mortality when used for primary or secondary prevention. Beneficial effects in patients with osteoporotic fractures or rheumatoid arthritis (RA) have been suggested but remain unproven. Cardiovascular morbidity and mortality are increased in patients with RA or systemic lupus erythematosus, who should undergo serum lipid assays. When these show dyslipidemia, statin therapy should be started according to current recommendations.