Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo 160-8582, Japan; Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW), Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan.
Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo 160-8582, Japan.
Spine J. 2019 Mar;19(3):493-500. doi: 10.1016/j.spinee.2018.07.022. Epub 2018 Aug 2.
Spinal epidural lipomatosis (SEL) is a condition in which excess lumbar epidural fat (EF) deposition often leads to compression of the cauda equina or nerve root. Although SEL is often observed in obese adults, no systematic research investigating the potential association between SEL and metabolic syndrome has been conducted.
To elucidate potential association between SEL and metabolic syndrome.
An observational study used data of a medical checkup.
We retrospectively reviewed data from consecutive subjects undergoing medical checkups. A total of 324 subjects (174 men and 150 women) were enrolled in this study.
The correlation of EF accumulation with demographic data and metabolic-related factors was evaluated.
The degree of EF accumulation was evaluated based on the axial views of lumbar magnetic resonance imaging. Visceral and subcutaneous fat areas were measured at the navel level using abdominal computed tomography. Metabolic syndrome was diagnosed according to the criteria of the Japanese Society of Internal Medicine. The correlation of SEL with metabolic syndrome and metabolic-related conditions was statistically evaluated.
The degree of EF accumulation demonstrated a significant correlation to body mass index, abdominal circumference, and visceral fat area. However, age, body fat percentage, and subcutaneous fat area showed no correlation with the degree of EF accumulation. Logistic regression analysis revealed that metabolic syndrome (odds ratio [OR]=3.8, 95% confidence interval [CI]=1.5-9.6) was significantly associated with SEL. Among the diagnostic criteria for metabolic syndrome, visceral fat area ≥100 cm (OR=4.8, 95% CI=1.5-15.3) and hypertension (OR=3.5, 95% CI=1.1-11.8) were observed to be independently associated with SEL.
This is the first study to demonstrate that metabolic syndrome is associated with SEL in a relatively large, unbiased population. Our data suggest that metabolic-related conditions are potentially related to EF deposition and that SEL could be a previously unrecognized manifestation of metabolic syndrome.
硬膜外脂肪增多症（SEL）是一种由于腰椎硬膜外脂肪（EF）过度沉积导致马尾或神经根受压的疾病。尽管 SEL 常发生于肥胖的成年人中，但目前尚未有研究系统地探讨 SEL 与代谢综合征之间的潜在关联。
阐明 SEL 与代谢综合征之间的潜在关联。
本研究采用观察性研究设计，使用体检数据。
我们回顾性分析了连续接受体检的受试者的数据。本研究共纳入 324 例受试者（男 174 例，女 150 例）。
评估 EF 堆积与人口统计学数据和代谢相关因素的相关性。
根据腰椎磁共振成像的轴位图像评估 EF 堆积程度。使用腹部 CT 在脐水平测量内脏和皮下脂肪面积。根据日本内科学会的标准诊断代谢综合征。统计学评估 SEL 与代谢综合征和代谢相关疾病的相关性。
EF 堆积程度与体重指数、腰围和内脏脂肪面积显著相关。然而，年龄、体脂百分比和皮下脂肪面积与 EF 堆积程度无相关性。Logistic 回归分析显示，代谢综合征（比值比 [OR]=3.8，95%置信区间 [CI]=1.5-9.6）与 SEL 显著相关。在代谢综合征的诊断标准中，内脏脂肪面积≥100cm（OR=4.8，95%CI=1.5-15.3）和高血压（OR=3.5，95%CI=1.1-11.8）与 SEL 独立相关。
这是第一项在相对较大的、无偏倚人群中证明代谢综合征与 SEL 相关的研究。我们的数据表明，代谢相关情况可能与 EF 沉积有关，SEL 可能是代谢综合征之前未被识别的一种表现。
