Takahata Masahiko, Koike Yoshinao, Endo Tsutomu, Ikegawa Shiro, Imagama Shiro, Kato Satoshi, Kanayama Masahiro, Kobayashi Kazuyoshi, Kaito Takashi, Sakai Hiroaki, Kawaguchi Yoshiharu, Oda Itaru, Terao Chikashi, Kanto Tomoya, Taneichi Hiroshi, Iwasaki Norimasa
Department of Orthopaedic Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Shimotuga, 321-0293, Japan; Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan; Laboratory for Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan.
Spine J. 2025 Jan;25(1):80-90. doi: 10.1016/j.spinee.2024.09.023. Epub 2024 Sep 26.
Growing evidence suggests that obesity is implicated in the progression of heterotopic ossification of the posterior longitudinal ligament of the spine (OPLL), a major cause of myelopathy in Asians. However, it remains unclear whether dysregulation of adipokine production due to fat accumulation contributes to OPLL progression.
To determine whether adipose-derived biochemical signals are associated with OPLL development or severity.
STUDY DESIGN/SETTING: A nationwide, multicenter, case-control study.
Patients with symptomatic thoracic OPLL (T-OPLL) who received treatment between June 2017 and March 2021 and 111 controls without OPLL.
OPLL severity index based on whole-spine computed tomography.
Serum concentrations of adipokines, including leptin (Lep), tumor necrosis factor α (TNFα), and adiponectin (Adpn), as well as the Adpn/Lep ratio-an indicator of adipokine production dysregulation-were compared between the multiple-region OPLL and the single-region OPLL groups. Regression analysis was performed to examine the correlation between adipokine concentrations and OPLL severity index, which was calculated using whole-spine computed tomography images of 77 patients with T-OPLL within 3 years of onset. Using propensity score matching, the adipokine profiles of 59 patients with T-OPLL were compared with those of 59 non-OPLL controls.
Patients with multiple-region OPLL exhibited a higher body mass index (BMI), lower serum Adpn/Lep ratio, and higher serum concentration of osteocalcin (OCN) than those with single-region OPLL. The OPLL severity index exhibited a weak positive correlation with BMI and serum Lep levels and a weak negative correlation with the Adpn/Lep ratio. Serum TNFα and OCN concentrations were significantly higher in patients with T-OPLL than in controls with similar age, sex, and BMI.
Patients with diffuse OPLL over the entire spine are often metabolically obese with low Adpn/Lep ratios. In patients with OPLL, TNFα and OCN serum concentrations were essentially elevated regardless of obesity, suggesting a potential association with OPLL development. Considering the absence of therapeutic drugs for OPLL, the findings presented herein offer valuable insights that can aid in identifying therapeutic targets and formulating strategies to impede its progression.
越来越多的证据表明，肥胖与脊柱后纵韧带骨化（OPLL）的进展有关，OPLL是亚洲人脊髓病的主要原因。然而，脂肪堆积导致的脂肪因子分泌失调是否会促进OPLL的进展仍不清楚。
确定脂肪衍生的生化信号是否与OPLL的发生或严重程度相关。
研究设计/地点：一项全国性、多中心的病例对照研究。
2017年6月至2021年3月期间接受治疗的有症状的胸段OPLL（T-OPLL）患者和111名无OPLL的对照者。
基于全脊柱计算机断层扫描的OPLL严重程度指数。
比较多节段OPLL组和单节段OPLL组血清中瘦素（Lep）、肿瘤坏死因子α（TNFα）和脂联素（Adpn）等脂肪因子的浓度，以及作为脂肪因子分泌失调指标的Adpn/Lep比值。进行回归分析，以检验脂肪因子浓度与OPLL严重程度指数之间的相关性，该指数是使用77例发病3年内的T-OPLL患者的全脊柱计算机断层扫描图像计算得出的。采用倾向评分匹配法，比较59例T-OPLL患者和59例非OPLL对照者的脂肪因子谱。
多节段OPLL患者的体重指数（BMI）更高，血清Adpn/Lep比值更低，血清骨钙素（OCN）浓度更高。OPLL严重程度指数与BMI和血清Lep水平呈弱正相关，与Adpn/Lep比值呈弱负相关。T-OPLL患者的血清TNFα和OCN浓度显著高于年龄、性别和BMI相似的对照者。
全脊柱弥漫性OPLL患者通常存在代谢性肥胖，Adpn/Lep比值较低。在OPLL患者中，无论是否肥胖，血清TNFα和OCN浓度均基本升高，提示其与OPLL的发生可能存在关联。考虑到目前尚无OPLL的治疗药物，本文的研究结果为识别治疗靶点和制定阻止其进展的策略提供了有价值的见解。
