The association of lumbar intervertebral disc degeneration on magnetic resonance imaging with body mass index in overweight and obese adults: A population-based study

Authors

  • Dino Samartzis,

    Corresponding author
    1. University of Hong Kong, Pokfulam, Hong Kong, China
    • Department of Orthopaedics and Traumatology, Queen Mary Hospital, Professorial Block, 5th Floor, 102 Pokfulam Road, Pokfulam, Hong Kong, China
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  • Jaro Karppinen,

    1. University of Oulu, Oulu, Finland
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  • Danny Chan,

    1. University of Hong Kong, Pokfulam, Hong Kong, China
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  • Keith D. K. Luk,

    1. University of Hong Kong, Pokfulam, Hong Kong, China
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  • Kenneth M. C. Cheung

    Corresponding author
    1. University of Hong Kong, Pokfulam, Hong Kong, China
    • Department of Orthopaedics and Traumatology, Queen Mary Hospital, Professorial Block, 5th Floor, 102 Pokfulam Road, Pokfulam, Hong Kong, China
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    • Dr. Cheung has received consulting fees, speaking fees, and/or honoraria from Synthes, AOSpine, and Ellipse Technologies (less than $10,000 each) and holds patents on shape memory alloy reduction technologies, methods for antibacterial implants, and resorbable metallic materials.


Abstract

Objective

To investigate the association of being overweight or obese with the presence, extent, and severity of lumbar disc degeneration on magnetic resonance imaging (MRI) in adults.

Methods

A population-based cross-sectional study of 2,599 southern Chinese volunteers was conducted. Subjects underwent radiographic and clinical assessment, and weight and height were measured. Sagittal T2-weighted MRIs of the lumbar spine were obtained. The presence, extent, and severity of disc degeneration and additional radiographic and clinical parameters were assessed. Asian-modified body mass index (BMI) (kg/m2) categories were used. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated.

Results

The study included 1,040 men and 1,559 women (mean age 41.9 years). Disc degeneration was noted in 1,890 subjects (72.7%). BMI was significantly higher in subjects with disc degeneration (mean 23.3 kg/m2) than in subjects without degeneration (mean 21.7 kg/m2) (P < 0.001). A significant increase in the number of degenerated levels (P < 0.001), global severity of disc degeneration (P < 0.001), and end-stage disc degeneration with disc space narrowing (P < 0.001) was noted with elevated BMI, in particular in overweight and obese subjects. In the adjusted multivariate logistic regression model, there was a positive linear trend (r2 = 0.99) between BMI and the overall presence of disc degeneration in overweight (OR 1.30 [95% CI 1.03–1.62]) and obese (OR 1.79 [95% CI 1.17–2.74]) subjects. End-stage disc degeneration with disc space narrowing was significantly more pronounced in obese subjects (adjusted OR 1.72 [95% CI 1.23–2.41] [reference normal weight]).

Conclusion

Our findings, in one of the largest studies to systematically assess lumbar disc degeneration on MRI, indicated a significant association between the presence, extent, and global severity of disc degeneration with weight in overweight and obese adults.

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