PMID- 38361008
OWN - NLM
STAT- Publisher
LR  - 20240216
IS  - 1432-0932 (Electronic)
IS  - 0940-6719 (Linking)
DP  - 2024 Feb 15
TI  - The effect of diabetes mellitus on lumbar disc degeneration: an MRI-based study.
LID - 10.1007/s00586-024-08150-8 [doi]
AB  - PURPOSE: This study aims to analyse the effect of diabetes mellitus (DM) on the 
      radiological changes of Magnetic Resonance Imaging (MRI) on the intervertebral 
      discs and paravertebral muscle to investigate the effect of DM on spinal 
      degeneration. METHODS: This retrospective study initially included 262 patients 
      who underwent treatment between January 2020 and December 2021 because of lumbar 
      disc herniation. Amongst these patients, 98 patients suffered from type 2 
      diabetes mellitus (T2DM) for more than five years; this is the poorly controlled 
      group (haemoglobin A1c (HbA1c) >/= 6.5%; BMI: 26.28 +/- 3.60; HbA1c: 7.5, IQR = 1.3). 
      Another 164 patients without T2DM are included in the control group. The data 
      collected and analysed include gender, age, smoking, alcohol use, disease course, 
      Charlson Comorbidity Index, BMI, and radiological parameters including disc 
      height, modified Pfirrmann grading scores, percentage of fat infiltration area of 
      paravertebral muscle, and pathological changes of the endplate. RESULTS: After 
      propensity score-matched analysis, the difference in general data between the 
      control and T2DM groups was eliminated, and 186 patients were analysed. The 
      modified Pfirrmann grading scores showed statistical differences in every lumbar 
      segment, suggesting that the T2DM group suffered from greater disc degeneration 
      at all L1-S1 segments compared with the control group. The disc height from L1/2 
      to L5/S1 was not statistically different between the two groups. Compared to the 
      T2DM group, the control group had a lower percentage of fat infiltration areas in 
      L4/5 and L5/S1 paravertebral muscle, whereas L1/2 to L3/4 showed no statistical 
      difference. The T2DM group had more pathological changes of cartilage endplate 
      compared with the control group. CONCLUSIONS: Prolonged uncontrolled 
      hyperglycaemia may contribute to lumbar disc degeneration, fatty infiltration of 
      the paraspinal muscles in the lower lumbar segments, and increased incidence of 
      endplate cartilage pathological changes in patients with degenerative disc 
      disease.
CI  - (c) 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, 
      part of Springer Nature.
FAU - Tian, Xiaoming
AU  - Tian X
AD  - Department of Spinal Surgery, Hebei Medical University Third Hospital, 139 
      Ziqiang Road, Shijiazhuang, 050051, Hebei, China.
FAU - Zhao, Hongwei
AU  - Zhao H
AD  - Department of Joint Surgery, Hebei Medical University Third Hospital, 139 Ziqiang 
      Road, Shijiazhuang, 050051, Hebei, China.
FAU - Yang, Sidong
AU  - Yang S
AD  - Department of Spinal Surgery, Hebei Medical University Third Hospital, 139 
      Ziqiang Road, Shijiazhuang, 050051, Hebei, China. sidongyang@hebmu.edu.cn.
FAU - Ding, Wenyuan
AU  - Ding W
AUID- ORCID: 0000-0002-7257-4316
AD  - Department of Spinal Surgery, Hebei Medical University Third Hospital, 139 
      Ziqiang Road, Shijiazhuang, 050051, Hebei, China. wenyuanding@hebmu.edu.cn.
LA  - eng
PT  - Journal Article
DEP - 20240215
PL  - Germany
TA  - Eur Spine J
JT  - European spine journal : official publication of the European Spine Society, the 
      European Spinal Deformity Society, and the European Section of the Cervical Spine 
      Research Society
JID - 9301980
SB  - IM
OTO - NOTNLM
OT  - Degeneration
OT  - Diabetes mellitus
OT  - Intervertebral disc
OT  - Lumbar disc herniation
OT  - MRI
EDAT- 2024/02/16 00:43
MHDA- 2024/02/16 00:43
CRDT- 2024/02/16 00:00
PHST- 2023/09/21 00:00 [received]
PHST- 2024/01/20 00:00 [accepted]
PHST- 2023/12/15 00:00 [revised]
PHST- 2024/02/16 00:43 [medline]
PHST- 2024/02/16 00:43 [pubmed]
PHST- 2024/02/16 00:00 [entrez]
AID - 10.1007/s00586-024-08150-8 [pii]
AID - 10.1007/s00586-024-08150-8 [doi]
PST - aheadofprint
SO  - Eur Spine J. 2024 Feb 15. doi: 10.1007/s00586-024-08150-8.