Abstract
BackgroundDiabetes mellitus (DM) and low back pain which is mainly caused by degeneration of the intervertebral discs (IVDs) both are major public health problem worldwide. The present study was designed to investigate the association between type 2 diabetes mellitus (T2D) and severity of lumbar disc degeneration (LDD).MethodsWe retrospectively reviewed patients with low back pain visiting our spine clinic in 2014. Low back pain patients all have the lumbar MRI imaging and no previous treatment. One hundred fifty patients without T2D (group A) and 622 patients with T2D meeting the criteria were included. Sex, age, body mass index (BMI), high blood pressure (HBP), history of smoking, alcohol use, and duration of T2D were recorded. Patients with T2D were assigned to a well-controlled group (group B, n = 380) and a bad-controlled group (group C, n = 242). In group B, T2D duration of 148 patients was ≤ 10 years (group B1) and 232 patients > 10 years (group B2). In group C, T2D duration of 100 patients was ≤ 10 years (group C1) and 142 patients > 10 years (group C2). The severity of LDD was evaluated using the five-level Pfirrmann grading system. Data were analyzed using SPSS 19.0.ResultsDemographic data except age showed no difference among groups (P > 0.5). Compared to patients without T2D, patients with T2D showed more severe disc degeneration after removal of age effects (P < 0.05). From L1/2 to L5/S1, the average Pfirrmann scores between groups A and B1 showed no difference(P > 0.05); groups B2, C1, and C2 showed higher average Pfirrmann scores than group A (P < 0.05). Groups B2 and C2 showed higher average Pfirrmann scores than groups B1 and C1 (P < 0.05). Groups C1 and C2 showed higher average Pfirrmann scores than groups B1 and B2 (P < 0.05). From L1/2 to L5/S1, the severity of LDD was highly positively related to T2D duration both in groups B and C (P < 0.05).ConclusionsT2D duration > 10 years and a bad control of T2D were risk factors for LDD. The longer T2D duration was, the more severe disc degeneration would be.
Highlights
Diabetes mellitus (DM) and low back pain which is mainly caused by degeneration of the intervertebral discs (IVDs) both are major public health problem worldwide
There were no significant differences among the five groups for sex, body mass index (BMI), high blood pressure (HBP) incidence, history of smoking, and alcohol use (P > 0.05), but they significantly differed in age (P < 0.05) (Table 1)
From L1/2 to L5/S1, by removing the effects of age utilizing analysis of covariance (ANCOVA), average Pfirrmann scores of patients with a good control of type 2 diabetes mellitus (T2D) and T2D duration ≤ 10 years showed no significant difference with patients without T2D (P > 0.05)
Summary
Diabetes mellitus (DM) and low back pain which is mainly caused by degeneration of the intervertebral discs (IVDs) both are major public health problem worldwide. The present study was designed to investigate the association between type 2 diabetes mellitus (T2D) and severity of lumbar disc degeneration (LDD). Diabetes mellitus (DM) is a chronic disease and a major public health problem worldwide. It is associated with high blood glucose levels that result from insulin secretory defects or insulin resistance. Degeneration of the intervertebral discs (IVDs) is a major contributor to back, neck, and radicular pain. The resulting imbalance in catabolic and anabolic responses leads to the degeneration of IVD tissues, as well as disc herniation and radicular pain [4]. There are multiple risk factors for low back pain, it was reported
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