The Clinical Correlations between Diabetes, Cigarette Smoking and Obesity on Intervertebral Degenerative Disc Disease of the Lumbar Spine.
The Clinical Correlations between Diabetes, Cigarette Smoking and Obesity on Intervertebral Degenerative Disc Disease of the Lumbar Spine.
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DOI：
10.4184/asj.2017.11.3.337
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发表时间：
2017-06
影响因子：
2.3
通讯作者：
Wang JC
中科院分区：
文献类型：
--
作者：
Jakoi AM;Pannu G;D'Oro A;Buser Z;Pham MH;Patel NN;Hsieh PC;Liu JC;Acosta FL;Hah R;Wang JC
对一个全国性的私人保险数据库进行回顾性分析。采用卡方分析和线性回归模型来衡量结果。
本研究的目的是调查腰椎退行性椎间盘疾病、糖尿病、肥胖和吸烟之间的任何关系。
糖尿病、肥胖和吸烟是已知的合并症，它们各自对退行性椎间盘疾病有影响。大多数研究只是在小规模人群中进行的。还没有研究在大量患者队列中对这些情况的组合进行调查，也没有研究它们对退行性椎间盘疾病的综合影响。
使用PearlDiver软件（PearlDiver公司，美国印第安纳州韦恩堡）对全国性的哈门那保险数据库中的保险账单代码进行回顾性分析，以确定被诊断为腰椎间盘退行性疾病且伴有或不伴有肥胖、糖尿病和/或吸烟相关合并症的患者的趋势。将在与腰椎间盘退行性疾病诊断相同的患者记录中因合并症诊断而计费的患者与因腰椎间盘退行性疾病但无合并症而计费的患者随时间进行比较。本稿件无资金来源且无利益冲突。
数据库中被诊断为腰椎间盘退行性疾病的患者总数和患病率（每10,000人）分别增加了241.4%和130.3%。在该人群中同时被诊断为肥胖、糖尿病、吸烟或其组合的患者子集明显高于单独被诊断为腰椎间盘退行性疾病的患者（所有情况均p <0.05）。被诊断为腰椎间盘退行性疾病且吸烟的患者数量比被诊断为腰椎间盘退行性疾病且患有糖尿病或肥胖的患者数量增加得更为显著（p <0.05）。被诊断为腰椎间盘退行性疾病、吸烟和肥胖的患者数量比被诊断为腰椎间盘退行性疾病且患有任何其他单一合并症或合并症组合的患者数量增加得更为显著（p <0.05）。
糖尿病、肥胖和吸烟都与腰椎退行性椎间盘疾病的诊断增加显著相关。吸烟和肥胖的组合对腰椎退行性椎间盘疾病发病率的增加具有协同作用。患者教育和预防保健是预防普通人群中退行性椎间盘疾病的一个重要目标。
Retrospective analysis of a nationwide private insurance database. Chi-square analysis and linear regression models were utilized for outcome measures. The purpose of this study was to investigate any relationship between lumbar degenerative disc disease, diabetes, obesity and smoking tobacco. Diabetes, obesity, and smoking tobacco are comorbid conditions known to individually have effect on degenerative disc disease. Most studies have only been on a small populous scale. No study has yet to investigate the combination of these conditions within a large patient cohort nor have they reviewed the combination of these conditions on degenerative disc disease. A retrospective analysis of insurance billing codes within the nationwide Humana insurance database was performed, using PearlDiver software (PearlDiver, Inc., Fort Wayne, IN, USA), to identify trends among patients diagnosed with lumbar disc degenerative disease with and without the associated comorbidities of obesity, diabetes, and/or smoking tobacco. Patients billed for a comorbidity diagnosis on the same patient record as the lumbar disc degenerative disease diagnosis were compared over time to patients billed for lumbar disc degenerative disease without a comorbidity. There were no sources of funding for this manuscript and no conflicts of interest. The total number and prevalence of patients (per 10,000) within the database diagnosed with lumbar disc degenerative disease increased by 241.4% and 130.3%, respectively. The subsets of patients within this population who were concurrently diagnosed with either obesity, diabetes, tobacco use, or a combination thereof, was significantly higher than patients diagnosed with lumbar disc degenerative disease alone (p <0.05 for all). The number of patients diagnosed with lumbar disc degenerative disease and smoking rose significantly more than patients diagnosed with lumbar disc degenerative disease and either diabetes or obesity (p <0.05). The number of patients diagnosed with lumbar disc degenerative disease, smoking and obesity rose significantly more than the number of patients diagnosed with lumbar disc degenerative disease and any other comorbidity alone or combination of comorbidities (p <0.05). Diabetes, obesity and cigarette smoking each are significantly associated with an increased diagnosis of lumbar degenerative disc disease. The combination of smoking and obesity had a synergistic effect on increased rates of lumbar degenerative disc disease. Patient education and preventative care is a vital goal in prevention of degenerative disc disease within the general population.