2型糖尿病对腰椎间盘退变的潜在影响：一项回顾性单中心研究。
The potential effect of type 2 diabetes mellitus on lumbar disc degeneration: a retrospective single-center study.
作者信息
Liu Xiaoming, Pan Fumin, Ba Zhaoyu, Wang Shanjin, Wu Desheng
机构信息
Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150# Jimo RD, Pudong New Area, Shanghai, 200120, China.
出版信息
J Orthop Surg Res. 2018 Mar 14;13(1):52. doi: 10.1186/s13018-018-0755-8.
BACKGROUND
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).
METHODS
We 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.
RESULTS
Demographic 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).
CONCLUSIONS
T2D 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.
背景
糖尿病（DM）和主要由椎间盘退变引起的腰痛都是全球范围内的重大公共卫生问题。本研究旨在探讨2型糖尿病（T2D）与腰椎间盘退变（LDD）严重程度之间的关联。
方法
我们回顾性分析了2014年到我们脊柱门诊就诊的腰痛患者。所有腰痛患者均有腰椎MRI影像且未曾接受过治疗。纳入150例无T2D的患者（A组）和622例符合标准的T2D患者。记录患者的性别、年龄、体重指数（BMI）、高血压（HBP）、吸烟史、饮酒情况以及T2D病程。将T2D患者分为血糖控制良好组（B组，n = 380）和血糖控制不佳组（C组，n = 242）。在B组中，148例患者的T2D病程≤10年（B1组），232例患者的T2D病程>10年（B2组）。在C组中，100例患者的T2D病程≤10年（C1组），142例患者的T2D病程>10年（C2组）。采用五级Pfirrmann分级系统评估LDD的严重程度。使用SPSS 19.0软件进行数据分析。
结果
除年龄外，各组间人口统计学数据无差异（P > 0.5）。去除年龄因素后，T2D患者的椎间盘退变比无T2D患者更严重（P < 0.05）。从L1/2到L5/S1，A组和B1组之间的平均Pfirrmann评分无差异（P > 0.05）；B2组、C1组和C2组的平均Pfirrmann评分高于A组（P < 0.05）。B2组和C2组的平均Pfirrmann评分高于B1组和C1组（P < 0.05）。C1组和C2组的平均Pfirrmann评分高于B1组和B2组（P < 0.05）。从L1/2到L5/S1，B组和C组中LDD的严重程度与T2D病程均呈高度正相关（P < 0.05）。
结论
T2D病程>10年以及T2D控制不佳是LDD的危险因素。T2D病程越长，椎间盘退变越严重。
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