Abstract
This study investigated associations between measures of adiposity from age 36 and spine shape at 60–64 years. Thoracolumbar spine shape was characterised using statistical shape modelling on lateral dual-energy x-ray absorptiometry images of the spine from 1529 participants of the MRC National Survey of Health and Development, acquired at age 60–64. Associations of spine shape modes with: 1) contemporaneous measures of total and central adiposity (body mass index (BMI), waist circumference (WC)) and body composition (android:gynoid fat mass ratio and lean and fat mass indices, calculated as whole body (excluding the head) lean or fat mass (kg) divided by height2 (m)2); 2) changes in total and central adiposity between age 36 and 60–64 and 3) age at onset of overweight, were tested using linear regression models. Four modes described 79% of the total variance in spine shape. In men, greater lean mass index was associated with a larger lordosis whereas greater fat mass index was associated with straighter spines. Greater current BMI was associated with a more uneven curvature in men and with larger anterior-posterior (a-p) vertebral diameters in both sexes. Greater WC and fat mass index were also associated with a-p diameter in both sexes. There was no clear evidence that gains in BMI and WC during earlier stages of adulthood were associated with spine shape but younger onset of overweight was associated with a more uneven spine and greater a-p diameter. In conclusion, sagittal spine shapes had different associations with total and central adiposity; earlier onset of overweight and prior measures of WC were particularly important.
Highlights
Spinal column and vertebral shape vary greatly between individuals [1,2,3] and change throughout life
We have explored the relationships between spinal shape in early old-age (60–64 years old), characterised by Statistical shape modelling (SSM), and changes in body mass index (BMI) and waist circumference (WC) throughout adult life in the Medical Research Council (MRC) National Survey of Health and Development
Shape variation associated with greater BMI and WC was found mainly in the evenness of the lumbar curvature and in the anterior-posterior vertebral diameter relative to the vertebral height rather than in the gross curvature of the spine
Summary
Spinal column and vertebral shape vary greatly between individuals [1,2,3] and change throughout life. Spinal curvatures help stabilise the body’s centre of mass and develop from childhood to young adulthood, with increases in lumbar lordosis and thoracic kyphosis [4, 5]. Exposure to heavy body weight or large increases in weight, especially over a lifetime, may result in adaptations to vertebral, and, spinal, shape. Studies have shown positive associations between body mass index (BMI) and lumbar lordosis in young adults aged 18–25 and in post-menopausal women [7,8,9]. A high BMI has been implicated in low back pain prevalence (LBP) [12], due to both mechanical and metabolic effects. Urquhart and colleagues [13] demonstrated a metabolic effect of high fat mass on increasing intensity of low back pain
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