Ahorukomeye Peter, Mahajan Arushi, Du Jerry Y, Yu Charles C, Bhandutia Amit K, Ahn Nicholas U
University Hospitals Cleveland Medical Center, Cleveland, OH.
Case Western Reserve School of Medicine, Cleveland, OH.
Spine (Phila Pa 1976). 2023 Jan 15;48(2):137-142. doi: 10.1097/BRS.0000000000004485. Epub 2022 Sep 16.
Retrospective cross-sectional analysis.
Degenerative changes are a major contributor to chronic neck pain. According to the vascular hypothesis of disk disease, atherosclerosis of the segmental arteries contributes to ischemia of the lumbar disks and resulting degenerative changes. Prior studies have demonstrated an association between atherosclerotic risk factors and lumbar degenerative disease. Similarly, atherosclerosis may contribute to cervical disk degeneration. Cardiovascular disease is associated with the development of atherosclerosis, particularly in small vessels to the cervical spine. Hypercholesterolemia is a major contributor to the morbidity associated with cardiovascular disease. This study aims to examine the relationship between hypercholesterolemia and neck pain.
Analysis was focused on the respondents to neck pain items of the standardized questionnaire. Odds ratios were calculated, and logistic regression analyses adjusted for demographic, education, and mental health conditions.
There were 30,461 participants in the 2018 Medicare Expenditure Panel Survey (MEPS) survey. Of those, 1049 (3.4%) subjects responded to presence of a diagnosis of cervical disorders with neck pain. Mean age of respondents was 62.6±16.1. Overall prevalence of neck pain was 21.1%. Prevalence of neck pain was similar by age, sex, education level, and occupation ( P >0.05 for each). Neck pain was more prevalent in white race and lower total family income ( P <0.05). Current everyday smokers also had higher prevalence of neck pain ( P <0.05). Logistic regression analysis revealed a higher prevalence of neck pain in those with hypercholesterolemia after controlling for relevant covariates (adjusted odds ratio=1.54, 95% CI: 1.08-2.22, P =0.018).
Subjects with hypercholesterolemia were 54% more likely to have neck pain after controlling for confounders. This suggests that hypercholesterolemia has a role to play in degeneration of the cervical spine. Therefore, prevention and proper management of high cholesterol may curtail the development and progression of degenerative cervical disk disease and thus, neck pain.
回顾性横断面分析。
退行性变是慢性颈痛的主要原因。根据椎间盘疾病的血管假说，节段性动脉的动脉粥样硬化导致腰椎间盘缺血并引发退行性变。先前的研究已证明动脉粥样硬化危险因素与腰椎退行性疾病之间存在关联。同样，动脉粥样硬化可能导致颈椎间盘退变。心血管疾病与动脉粥样硬化的发展相关，尤其是在颈椎的小血管中。高胆固醇血症是心血管疾病相关发病率的主要促成因素。本研究旨在探讨高胆固醇血症与颈痛之间的关系。
分析聚焦于标准化问卷中颈痛项目的受访者。计算优势比，并对人口统计学、教育程度和心理健康状况进行逻辑回归分析。
2018年医疗保险支出小组调查（MEPS）中有30461名参与者。其中，1049名（3.4%）受试者对伴有颈痛的颈椎疾病诊断作出了回应。受访者的平均年龄为62.6±16.1岁。颈痛的总体患病率为21.1%。颈痛的患病率在年龄、性别、教育程度和职业方面相似（每项P>0.05）。颈痛在白人种族和家庭总收入较低者中更为普遍（P<0.05）。当前的日常吸烟者颈痛患病率也较高（P<0.05）。逻辑回归分析显示，在控制相关协变量后，高胆固醇血症患者的颈痛患病率更高（调整后的优势比=1.54，95%置信区间：1.08-2.22，P=0.018）。
在控制混杂因素后，高胆固醇血症患者出现颈痛的可能性要高54%。这表明高胆固醇血症在颈椎退变中起作用。因此，预防和适当管理高胆固醇可能会抑制退行性颈椎间盘疾病的发生和发展，从而减轻颈痛。
