The Effect of Diabetes and Disease Duration on Disc Degeneration and Subcutaneous Adipose Tissue Thickness
- 1. Department of Internal Medicine, Adıyaman Training and Research Hospital, Adıyaman, Türkiye.
- 2. Department of Radiology, Adıyaman University Faculty of Medicine, Adıyaman, Türkiye.
- 3. Department of Internal Medicine, VM Medical Park Pendik Hospital, Istanbul, Türkiye.
- 4. Department of Internal Medicine, Adıyaman University Faculty of Medicine, Adıyaman, Türkiye.
Description
Özet
Diyabetes mellitus (DM) varlığı ve hastalık süresinin, intervertebral disk dejenerasyonu, epifizyal plak dejenerasyonu ve cilt altı yağ dokusu kalınlığı değişiklikleri ile ilişkili olup olmadığını belirlemeyi amaçladığımız bu çalışmaya 2020-2022 yılları arasında iç hastalıkları polikliniğine başvuran ve bel ve/veya bacak ağrısı nedeni ile lomber omurga manyetik rezonans görüntülemesi çekilen diyabetik hastalar ve diyabetik olmayan katılımcılar (kontrol grubu) dahil edildi. DM hastaları ve kontrol grubunda disk dejenerasyonu, epifizyal plak dejenerasyonu ve cilt altı yağ dokusu kalınlığı parametreleri retrospektif olarak incelendi ve sonuçlar istatistiksel açıdan değerlendirildi. Hasta grubunda 80 DM hastası vardı, bu hastaların 25’i (%31.3) erkek ve 55’i (%68.8) kadın idi. Kontrol grubunda ise toplamda 121 katılımcı vardı ve bunların 39’u (%32.2) erkek ve 82’si (%67.8) kadın idi. Hasta grubun yaş ortalaması 57.85±10.76 iken, kontrol grubunun yaş ortalaması 54.23±13.09 idi. DM süresi ile disk dejenerasyonu, epifizyal plak dejenerasyonu ve cilt altı yağ dokusu kalınlık değişikliği arasında anlamlı bir fark yoktu. Bununla beraber, kontrol grubu ile DM’li hasta grubu arasında disk dejenerasyonu ve epifizyal plak dejenerasyonu açısından anlamlı derecede farklılık mevcuttu, sırasıyla p=0.003 ve p=0.017. Çalışmamız diyabeti olan hastalarda hastalık süresinden bağımsız olarak disk dejenerasyonu ve epifizyal plak dejenerasyonuna yatkınlığın arttığını göstermiştir. Diyabetik hastalığın kontrolü ve tedavisi sekonder komplikasyonların önlenmesine önemli katkı sunacaktır.
Abstract
In this study, we aimed to determine whether the presence and duration of diabetes mellitus (DM) is associated with changes in intervertebral disc degeneration, epiphyseal plaque degeneration, and subcutaneous fat tissue thickness. Diabetic patients and non-diabetic participants (control group) who applied to the internal medicine outpatient clinic between 2020-2022 and had lumbar spine magnetic resonance imaging due to low back and/or leg pain were included the study. Disc degeneration, epiphyseal plaque degeneration, and subcutaneous fat tissue thickness parameters of DM patients and control group were reviewed retrospectively, and the results were statistically evaluated. There were 80 DM patients in the patient group, 25 (31.3%) of these patients were male and 55 (68.8%) were female. There was a total of 121 participants in the control group, of which 39 (32.2%) were male and 82 (67.8%) were female. The mean age of the patient group was 57.85±10.76 years, while the mean age of the control group was 54.23±13.09 years. There was no significant difference between the duration of DM and disc degeneration, epiphyseal plaque degeneration, and subcutaneous adipose tissue thickness. However, there was a significant difference between the control group and the DM patient group in terms of disc degeneration and epiphyseal plaque degeneration (p=0.003 and p=0.017, respectively). This study reveals that patients with diabetes have an increased susceptibility to disc degeneration and epiphyseal plaque degeneration, regardless of disease duration. Control and treatment of diabetic disease will make an important contribution to the prevention of secondary complications.
Notes
Files
lms.2023.26.v2.pdf
Files
(403.5 kB)
Name | Size | Download all |
---|---|---|
md5:629ed6814a56f777730dd466960c6ad1
|
403.5 kB | Preview Download |
Additional details
References
- 1. Kong CG, Park JB, Kim MS, Park EY. High glucose accelerates autophagy in adult rat intervertebral disc cells. Asian Spine J 2014; 8(5): 543-8. [Crossref] [PubMed]
- 2. Schreiber AK, Nones CF, Reis RC, Chichorro JG, Cunha JM. Diabetic neuropathic pain: Physiopathology and treatment. World J Diabetes 2015; 6(3): 432-44. [Crossref] [PubMed]
- 3. Chen S, Liao M, Li J, Peng H, Xiong M. The correlation between microvessel pathological changes of the endplate and degeneration of the intervertebral disc in diabetic rats. Exp Ther Med 2020; 20(5): 1. [Crossref] [PubMed]
- 4. Vergroesen PP, Kingma I, Emanuel KS, Hoogendoorn RJ, Welting TJ, van Royen BJ, et al. Mechanics and biology in intervertebral disc degeneration: a vicious circle. Osteoarthritis Cartilage 2015; 23(7): 1057-70. [Crossref] [PubMed]
- 5. Garber AM, Azad TD, Dixit A, Farid M, Sung E, Vail D, et al. Medicare savings from conservative management of low back pain. Am J Manag Care 2018; 24(10): e332-e337. [PubMed]
- 6. Dowdell J, Erwin M, Choma T, Vaccaro A, Iatridis J, Cho SK. Intervertebral Disk Degeneration and Repair. Neurosurgery 2017; 80(3S): S46-S54. Erratum in: Neurosurgery 2018; 83(5): 1084. [Crossref] [PubMed]
- 7. Herger N, Bermudez-Lekerika P, Farshad M, Albers CE, Distler O, Gantenbein B, et al. Should Degenerated Intervertebral Discs of Patients with Modic Type 1 Changes Be Treated with Mesenchymal Stem Cells? Int J Mol Sci 2022; 23(5): 2721. [Crossref] [PubMed]
- 8. Ramanathan R, Firdous A, Dong Q, Wang D, Lee J, Vo N, et al. Investigation into the anti-inflammatory properties of metformin in intervertebral disc cells. JOR Spine 2022; 5(2): e1197. [Crossref] [PubMed]
- 9. Kadow T, Sowa G, Vo N, Kang JD. Molecular basis of intervertebral disc degeneration and herniations: what are the important translational questions? Clin Orthop Relat Res 2015; 473(6): 1903-12. [Crossref] [PubMed]
- 10. Risbud MV, Shapiro IM. Role of cytokines in intervertebral disc degeneration: pain and disc content. Nat Rev Rheumatol 2014; 10(1): 44-56. [Crossref] [PubMed]
- 11. Eller-Vainicher C, Cairoli E, Grassi G, Grassi F, Catalano A, Merlotti D, et al. Pathophysiology and Management of Type 2 Diabetes Mellitus Bone Fragility. J Diabetes Res 2020; 2020: 7608964. [Crossref] [PubMed]
- 12. Wang M, Tan Y, Shi Y, Wang X, Liao Z, Wei P. Diabetes and Sarcopenic Obesity: Pathogenesis, Diagnosis, and Treatments. Front Endocrinol (Lausanne) 2020; 11: 568. [Crossref] [PubMed]
- 13. Mahmoud M, Kokozidou M, Auffarth A, Schulze-Tanzil G. The Relationship between Diabetes Mellitus Type II and Intervertebral Disc Degeneration in Diabetic Rodent Models: A Systematic and Comprehensive Review. Cells 2020; 9(10): 2208. [Crossref] [PubMed]
- 14. Zhang Z, Lin J, Nisar M, Chen T, Xu T, Zheng G, et al. The Sirt1/P53 Axis in Diabetic Intervertebral Disc Degeneration Pathogenesis and Therapeutics. Oxid Med Cell Longev 2019; 2019: 7959573. [Crossref] [PubMed]
- 15. Fields AJ, Berg-Johansen B, Metz LN, Miller S, La B, Liebenberg EC, et al. Alterations in intervertebral disc composition, matrix homeostasis and biomechanical behavior in the UCD-T2DM rat model of type 2 diabetes. J Orthop Res 2015; 33(5): 738-46. [Crossref] [PubMed]
- 16. Mendonça CR, Noll M, de Carvalho Santos ASEA, Rodrigues APDS, Silveira EA. High prevalence of musculoskeletal pain in individuals with severe obesity: sites, intensity, and associated factors. Korean J Pain 2020; 33(3): 245-57. [Crossref] [PubMed]
- 17. Kaya SS, Akcaboy EY, Celik S, Goksu H, Baran M, Yildiz G, et al. A comparative and retrospective study on the efficacy of caudal epidural steroid injection plus ganglion impar block versus ganglion impar block in patients with coccydynia. Ann Med Res 2022; 29(12): 1413-7.
- 18. Illien-Jünger S, Lu Y, Qureshi SA, Hecht AC, Cai W, Vlassara H, et al. Chronic ingestion of advanced glycation end products induces degenerative spinal changes and hypertrophy in aging pre-diabetic mice. PLoS One 2015; 10(2): e0116625. [Crossref] [PubMed]
- 19. Brinjikji W, Diehn FE, Jarvik JG, Carr CM, Kallmes DF, Murad MH, et al. MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis. AJNR Am J Neuroradiol 2015; 36(12): 2394-9. [Crossref] [PubMed]
- 20. Kakadiya G, Gandbhir V, Soni Y, Gohil K, Shakya A. Diabetes Mellitus-A Risk Factor for the Development of Lumbar Disc Degeneration: A Retrospective Study of an Indian Population. Global Spine J 2022; 12(2): 215-20. [Crossref] [PubMed]
- 21. Shemesh S, Sidon E, Kaisler E, Sheinis D, Velkes S, Ohana N, et al. Diabetes mellitus is associated with increased elastin fiber loss in ligamentum flavum of patients with lumbar spinal canal stenosis: results of a pilot histological study. Eur Spine J 2018; 27(7): 1614-22. [Crossref] [PubMed]
- 22. Kim JA, Hwang SY, Chung HS, Kim NH, Seo JA, Kim SG, et al. Proportion and Characteristics of the Subjects with Low Muscle Mass and Abdominal Obesity among the Newly Diagnosed and Drug-Naïve Type 2 Diabetes Mellitus Patients. Diabetes Metab J 2019; 43(1): 105-13. [Crossref] [PubMed]