Miura Soya, Koike Yoshinao, Endo Tsutomu, Takahata Masahiko, Sudo Hideki, Kadoya Ken, Kanayama Masahiro, Fujita Ryo, Fukada Shotaro, Terkawi M Alaa, Yamada Katsuhisa, Ohnishi Takashi, Ukeba Daisuke, Tachi Hiroyuki, Hasegawa Yuichi, Ishii Misaki, Iwasaki Norimasa
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; Department of Orthopedics, Hakodate Central General Hospital, 33-2 Hon-cho, Hakodate, Hokkaido 040-8585, Japan.
Spine J. 2025 Jul;25(7):1428-1439. doi: 10.1016/j.spinee.2025.01.032. Epub 2025 Jan 30.
Recent studies have demonstrated a close association between the development of ossification of the posterior longitudinal ligament (OPLL) and obesity. However, the association between OPLL and visceral fat obesity, which is prevalent in the Asian population, remains unexplored.
To examine the impact of visceral fat obesity on the development of asymptomatic OPLL.
Single-institution cross-sectional study.
Between 2020 and 2021, data were collected from 249 Japanese individuals (147 men and 102 women) who underwent computed tomography (CT) to assess both the visceral fat content and OPLL.
We assessed patient background information, serum data, and CT images, including the abdominal circumference (cm), total fat area (cm), visceral fat area (cm), and subcutaneous fat area (cm) at the umbilicus level. OPLL localization was assessed using whole-spine CT images.
The individuals were categorized into 4 groups based on obesity and visceral fat: nonobesity without visceral fat (n=85), obesity without visceral fat (n=18), nonobesity with visceral fat (n=44), and obesity with visceral fat (n=102). OPLL was classified as localized or diffuse when present in the cervical spine alone or in the cervical and thoracic spine, respectively. The prevalence of each type of OPLL was compared between the groups. Multivariable analysis was conducted to calculate the effect size of body mass index (BMI) on the prevalence of OPLL, comparing the high and low visceral fat groups.
The obesity with visceral fat group exhibited a significantly higher proportion of diffuse OPLL than did the nonobesity without visceral fat group (27.5% vs 7.1%, p<.001). The effect size of BMI for the occurrence of diffuse OPLL was 2.1 times greater in the high visceral fat group (odds ratio [OR], 3.12; 95% confidence interval [CI], 1.66-5.87) than in the low visceral fat group (OR, 1.44; 95% CI, 0.64-3.22).
Our data show that visceral fat, in conjunction with BMI, influences the occurrence of OPLL in the Japanese population. This supports the hypothesis that systemic metabolic disorders share a disease mechanism with OPLL and indicates that the high prevalence of OPLL in Japan may be attributed to physical characteristics that promote visceral fat accumulation.
近期研究表明，后纵韧带骨化（OPLL）的发生与肥胖之间存在密切关联。然而，OPLL与亚洲人群中普遍存在的内脏脂肪型肥胖之间的关联仍未得到探索。
研究内脏脂肪型肥胖对无症状OPLL发生的影响。
单机构横断面研究。
在2020年至2021年期间，收集了249名接受计算机断层扫描（CT）以评估内脏脂肪含量和OPLL的日本个体（147名男性和102名女性）的数据。
我们评估了患者的背景信息、血清数据和CT图像，包括脐水平的腹围（cm）、总脂肪面积（cm）、内脏脂肪面积（cm）和皮下脂肪面积（cm）。使用全脊柱CT图像评估OPLL的定位。
根据肥胖和内脏脂肪将个体分为4组：无内脏脂肪的非肥胖组（n = 85）、无内脏脂肪的肥胖组（n = 18）、有内脏脂肪的非肥胖组（n = 44）和有内脏脂肪的肥胖组（n = 102）。当OPLL仅存在于颈椎或同时存在于颈椎和胸椎时，分别将其分类为局限性或弥漫性。比较各组中每种类型OPLL的患病率。进行多变量分析以计算体重指数（BMI）对OPLL患病率的效应大小，比较高内脏脂肪组和低内脏脂肪组。
有内脏脂肪的肥胖组弥漫性OPLL的比例显著高于无内脏脂肪的非肥胖组（27.5%对7.1%，p <.001）。高内脏脂肪组中BMI对弥漫性OPLL发生的效应大小是低内脏脂肪组的2.1倍（优势比[OR]，3.12；95%置信区间[CI]，1.66 - 5.87），而低内脏脂肪组的OR为1.44；95% CI，0.64 - 3.22）。
我们的数据表明，内脏脂肪与BMI共同影响日本人群中OPLL的发生。这支持了全身代谢紊乱与OPLL具有共同疾病机制的假设，并表明日本OPLL的高患病率可能归因于促进内脏脂肪积累的身体特征。
