Diabetes mellitus and intervertebral disc degeneration: a meta-analysis

Abstract

BackgroundDiabetes mellitus (DM) has been related to a higher risk of intervertebral disc degeneration (IVDD). However, the previous studies showed inconsistent results. We performed a systematic review and meta-analysis to comprehensively investigate the association between DM and IVDD in adult population. MethodsObservational studies relevant to the aim of the meta-analysis were retrieved by search of electronic databases including PubMed, Web of Science, and Embase. A random-effects model was used to combine the data by incorporating the influence of between-study heterogeneity. ResultsEleven observational studies involving 2881170 adults were included. Among them, 1211880 had DM. Compared to those with normoglycemia, patients with DM were associated with a higher odds ratio (OR) of IVDD (OR: 1.68, 95% confidence interval [CI]: 1.24 to 2.29, p < 0.001; I2= 98%). Further sensitivity analysis excluding database studies with IVDD diagnosed via International Classification of Disease codes showed consistent results (OR: 1.47, 95% CI: 1.06 to 2.02, p = 0.02) with no statistical heterogeneity (I2 = 0%). Subgroup analyses showed a stronger association between DM and IVDD in cohort studies than that in cross-sectional studies, in studies evaluating overall IVDD than that evaluating lumbar disc degeneration, and in studies that adjusted age and body mass index (BMI) than that did not (p for subgroup differences all < 0.05). Subgroup analyses according to study country and quality score did not significantly affect the association. ConclusionsDM may be associated with IVDD in adult population, which seems to be independent of age and BMI.