Associated Factors of Intervertebral Disc Degeneration—Current Results from a Population-Based Cohort: The Wakayama Spine Study

Abstract

Introduction Intervertebral disc degeneration (DD) is thought to be the first step of degenerative spinal changes. Furthermore, DD is considered to be one of the causes of several symptoms including low back pain (LBP). Although previous studies have investigated the association between DD and LBP as well as risk factors of DD, many of them are still controversial mainly because of the selection bias for the cohort. The purposes of this study were (1) to examine the association between the presence of DD and low back pain, and (2) to examine the risk factors related to DD (age, gender, body mass index [BMI], hyperlipidemia, diabetes mellitus [DM], peripheral artery disease [PAD], and smoking) using a large scale population-based cohort. Materials and Methods This was a cross-sectional study of the base-line data from the population-based cohort of Wakayama, western part of Japan, comprising 975 (men, 324; women, 651; mean age 66.4 years) of 1,011 participants (age, 21-97 years). The participants were subjected to the entire spine MRI and the lumbar intervertebral disc was evaluated according to the Pfirrmann classification system (1-3 = nondegeneration; 4, 5 = degeneration). Multiple logistic regression analysis was used to estimate the association between DD and low back pain after adjustment for age, gender, and BMI. Besides this, we analyzed the association between the presence of DD and the potential risk factors: age, gender, BMI, hyperlipidemia, diabetes mellitus (DM), peripheral artery disease (PAD), and smoking. Results The presence of DD was significantly associated with low back pain. The multiple logistic regression analysis indicated that older age, obesity, and hyperlipidemia were significant related factors of DD. Gender, DM, PAD, and smoking were not significantly related with DD in our cohort. Conclusion The current data provide the foundation for elucidating the causes and mechanisms of DD. However, there is a limitation concerning a temporal relationship between exposure and outcome due to the nature of cross-sectional study design. The second survey of the cohort, which is now ongoing, will provide important information in the near future. Disclosure of Interest None declared Reference Teraguchi M, Yoshimura N, Hashizume H, et al. Prevalence and distribution of intervertebral disc degeneration over the entire spine in a population-based cohort: the Wakayama Spine Study. Osteoarthritis Cartilage 2014;22(1):104–110