Factors associated with lumbar intervertebral disc degeneration in the elderly
Factors associated with lumbar intervertebral disc degeneration in the elderly
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DOI：
10.1016/j.spinee.2007.07.392
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发表时间：
2008-09-01
期刊：
影响因子：
4.5
通讯作者：
Ochiai, Naoyuki
中科院分区：
文献类型：
--
作者：
Hangai, Mika;Kaneoka, Koji;Ochiai, Naoyuki
背景：腰椎间盘退变（DD）先于腰椎退行性疾病。据报道，除正常衰老外，多种因素与DD有关，最近动脉粥样硬化和心血管疾病的危险因素（心血管危险因素）备受关注；然而，这些危险因素与 DD 之间的联系尚不清楚。目的：通过将磁共振图像 (MRI) 与可疑的椎间盘退变危险因素（如肥胖、心血管危险因素和动脉粥样硬化）相关联，我们希望澄清与 DD 相关的因素。研究设计/设置：一项观察性研究。患者样本：参加健康检查的 270 名成年人（51-86 岁） 结果指标：根据腰椎 MR T2 加权中矢状图像的信号强度评估 DD。方法：年龄、性别、体重指数 (BMI)、低密度脂蛋白胆固醇 (LDLc)、甘油三酯 (TG)、糖化血红蛋白 (HbA(1c))、臂踝脉搏波 评估了作为动脉粥样硬化指数的速度（baPWV）、作为骨矿物质密度（BMD）指数的通过跟骨定量超声评估计算出的骨声评估指数（OSI）、腰痛病史（LBP）、吸烟和饮酒习惯以及与职业和运动相关的身体负荷。评估 DD 和变量之间的单变量关系，最后使用每个椎间盘水平的逻辑回归计算每个因素与 DD 关联的比值比 (OR) 和 95% 置信区间 (0)。 结果：L1/2 (OR, 2.14)、L2/3 (OR, 3.56)、L3/4 (OR, 2.84) 和 L4/5 的衰老与 DD 显着相关 （或，3.05）；高BMI，1-2/3（OR，2.98）、L3/4（OR，3.58）、L4/5（OR，2.32）和L5/S1（OR，3.34）；高 LDLc，L4/5（OR，2.65）；职业举重，L1/2（OR，4.25）；和体育活动，L5/S1（OR，3.36）。结论：衰老、高 BMI、高 LDLc、职业举重和体育活动与 DD 相关。这项研究的结果让我们怀疑心血管危险因素和特定的身体负荷可能会导致 DD；然而，需要进行更多研究来进一步调查 DD 与这些因素之间的关联。 (C) 2008 Elsevier Inc. 保留所有权利。
BACKGROUND CONTEXT: Lumbar intervertebral disc degeneration (DD) precedes degenerative diseases of the lumbar spine. Various factors in addition to normal aging are reported to be associated with DD, and recently atherosclerosis and risk factors for cardiovascular diseases (cardiovascular risk factors) have received much attention; however, the links between these risk factors and DD are unclear.PURPOSE: By correlating magnetic resonance images (MRI) with suspected degenerative disc risk factors such as obesity, cardiovascular risk factors, and atherosclerosis, we hope to clarify the factors associated with DD.STUDY DESIGN/SETTING: An observational study.PATIENT SAMPLE: Two hundred seventy adults (51-86 years old) who participated in a health promotion program.OUTCOME MEASURES: DD evaluated based on the signal intensity of MR T2-weighted midsagittal images of the lumbar spine.METHODS: Age, gender, body mass index (BMI), low-density lipoprotein cholesterol (LDLc), triglyceride (TG), glycosylated hemoglobin (HbA(1c)), brachial-ankle pulse wave velocity (baPWV) as an index of atherosclerosis, osteo-sono-assessment index (OSI) calculated from quantitative ultrasound assessment of the calcaneus as an index of bone mineral density (BMD), history of low back pain (LBP), smoking and drinking habits, and physical loading related to occupations and sports were assessed. The univariate relationships between DD and the variables were evaluated, and finally, odds ratios (OR) and 95% confidence intervals (0) for the associations of each factor with DD were calculated using logistic regression at each disc level.RESULTS: Aging correlated significantly with DD of L1/2 (OR, 2.14), L2/3 (OR, 3.56), L3/4 (OR, 2.84), and L4/5 (OR, 3.05); high BMI, with 1-2/3 (OR, 2.98), L3/4 (OR, 3.58), L4/5 (OR, 2.32), and L5/S1 (OR, 3.34); high LDLc, with L4/5 (OR, 2.65); occupational lifting, with L1/2 (OR, 4.25); and sports activities, with L5/S1 (OR, 3.36).CONCLUSIONS: Aging, high BMI, high LDLc, occupational lifting, and sports activities are associated with DD. The results of this study raise our index of suspicion that cardiovascular risk factors and particular physical loading may contribute to DD; however additional studies are required to further investigate associations between DD and these factors. (C) 2008 Elsevier Inc. All rights reserved.