Is There a Relation Between Lateral Epicondylitis and Total Cholesterol Levels?

Abstract

To investigate whether high total cholesterol (TC) levels are associated with lateral epicondylitis (LE). We retrospectively reviewed all patients with LE who presented to our institution between 2011 and 2015. The inclusion criteria were a diagnosis of LE based on clinical history and physical examination findings and age between 40 and 55years. For healthy controls, we obtained data from a national cohort (sixth Korean National Health and Nutrition Examination Survey) aged between 40 and 55years. We compared TC levels between the groups, determined the incidence of hypercholesterolemia (TC level ≥ 240mg/dL) according to the occurrence of LE, and calculated odds ratios for the occurrence of LE. We also evaluated whether cholesterol levels were associated with clinical findings of LE, such as pain level, onset age, symptom duration, and number of corticosteroid injections. The study comprised 289 patients with LE (mean age, 47.9years) and 1,077 healthy individuals (mean age, 47.7years). TC levels were significantly higher in patients with LE than in healthy individuals (205.0mg/dL vs 194.6mg/dL, P < .001). The mean difference of 10.4mg/dL was clinically meaningful because a change of 10mg/dL with medical intervention is considered significant. The incidence of hypercholesterolemia was higher in LE patients than in healthy controls (16.6% vs 9.0%, P < .001). After adjustment for age, sex, body mass index, and glucose level, patients with hypercholesterolemia (TC level ≥ 240mg/dL) were 2.47 (95% confidence interval, 1.65-3.70) times more likely to experience LE than those with normal cholesterol levels (<200mg/dL). TC levels correlated with pain level, onset age, and number of corticosteroid injections. A clinically meaningful difference in TC levels was found between LE patients and healthy controls. Inaddition, the incidence of hypercholesterolemia was higher in LE patients than in controls. The present findings suggest a potential association between high TC levels and LE. Level III, case-control study.