Skip to main content
Top
Published in: European Spine Journal 9/2016

Open Access 01-09-2016 | Original Article

Does type 2 diabetes mellitus promote intervertebral disc degeneration?

Authors: Stella Maris Fabiane, Kirsten J. Ward, James C. Iatridis, Frances M. K. Williams

Published in: European Spine Journal | Issue 9/2016

Login to get access

Abstract

Purpose

LDD is an important cause of low back pain. Many people believe there is an adverse influence of type 2 diabetes (T2D) on lumbar intervertebral disc degeneration (LDD). We examined a population sample for epidemiological evidence of association.

Methods

Twin volunteers from the TwinsUK cohort having spine magnetic resonance (MR) scans coded for LDD and information about T2D were investigated in two ways. First, as a population sample and second as a cotwin case control study in twin pairs discordant for T2D. Other risk factors for LDD considered were age, body-mass index (BMI), smoking, and alcohol.

Results

In 956 twin volunteers T2D had a prevalence of 6.6 %. LDD score was higher in T2D twins (14.9 vs 13.1 p = 0.04) but was not an independent risk factor if the influence of age and BMI were included in the model. Discordant twin analysis (n = 33 pairs) showed no significant difference in LDD between twins having T2D and their unaffected cotwins.

Conclusions

Twins having T2D did manifest higher LDD scores but the effect was abrogated once BMI was included in multivariable analysis, showing it is not an independent risk factor for LDD. The population study had 80 % power at 0.1 significance level to detect a difference of 1.8 in LDD score (range of 0–60), so if there is an effect of T2D on LDD, it is likely to be small.
Literature
1.
go back to reference Endean A, Palmer KT, Coggon D (2011) Potential of magnetic resonance imaging findings to refine case definition for mechanical low back pain in epidemiological studies: a systematic review. Spine (Phila Pa 1976) 36:160–169. doi:10.1097/BRS.0b013e3181cd9adb CrossRef Endean A, Palmer KT, Coggon D (2011) Potential of magnetic resonance imaging findings to refine case definition for mechanical low back pain in epidemiological studies: a systematic review. Spine (Phila Pa 1976) 36:160–169. doi:10.​1097/​BRS.​0b013e3181cd9adb​ CrossRef
2.
go back to reference MacGregor AJ, Andrew T, Sambrook PN, Spector TD (2004) Structural, psychological, and genetic influences on low back and neck pain: a study of adult female twins. Arthritis Rheum 51:160–167. doi:10.1002/art.20236 CrossRefPubMed MacGregor AJ, Andrew T, Sambrook PN, Spector TD (2004) Structural, psychological, and genetic influences on low back and neck pain: a study of adult female twins. Arthritis Rheum 51:160–167. doi:10.​1002/​art.​20236 CrossRefPubMed
3.
go back to reference Anekstein Y, Smorgick Y, Lotan R, Agar G, Shalmon E, Floman Y, Mirovsky Y (2010) Diabetes mellitus as a risk factor for the development of lumbar spinal stenosis. Israel Med Assoc J 12:16–20 Anekstein Y, Smorgick Y, Lotan R, Agar G, Shalmon E, Floman Y, Mirovsky Y (2010) Diabetes mellitus as a risk factor for the development of lumbar spinal stenosis. Israel Med Assoc J 12:16–20
5.
go back to reference Samartzis D, Karppinen J, Chan D, Luk KD, Cheung KM (2012) The association of lumbar intervertebral disc degeneration on magnetic resonance imaging with body mass index in overweight and obese adults: a population-based study. Arthritis Rheum 64:1488–1496. doi:10.1002/art.33462 CrossRefPubMed Samartzis D, Karppinen J, Chan D, Luk KD, Cheung KM (2012) The association of lumbar intervertebral disc degeneration on magnetic resonance imaging with body mass index in overweight and obese adults: a population-based study. Arthritis Rheum 64:1488–1496. doi:10.​1002/​art.​33462 CrossRefPubMed
6.
go back to reference Fields AJ, Berg-Johansen B, Metz LN, Miller S, La B, Liebenberg EC, Coughlin DG, Graham JL, Stanhope KL, Havel PJ, Lotz JC (2015) Alterations in intervertebral disc composition, matrix homeostasis and biomechanical behavior in the UCD-T2DM rat model of type 2 diabetes. J Orthop Res 33:738–746. doi:10.1002/jor.22807 CrossRefPubMedPubMedCentral Fields AJ, Berg-Johansen B, Metz LN, Miller S, La B, Liebenberg EC, Coughlin DG, Graham JL, Stanhope KL, Havel PJ, Lotz JC (2015) Alterations in intervertebral disc composition, matrix homeostasis and biomechanical behavior in the UCD-T2DM rat model of type 2 diabetes. J Orthop Res 33:738–746. doi:10.​1002/​jor.​22807 CrossRefPubMedPubMedCentral
8.
go back to reference Williams FM, Popham M, Livshits G, Sambrook PN, Spector TD, MacGregor AJ (2010) A response to Videman et al., “challenging the cumulative injury model: positive effects of greater body mass on disc degeneration”. Spine J 10:571–572. doi:10.1016/j.spinee.2010.03.002 (author reply 572) CrossRefPubMed Williams FM, Popham M, Livshits G, Sambrook PN, Spector TD, MacGregor AJ (2010) A response to Videman et al., “challenging the cumulative injury model: positive effects of greater body mass on disc degeneration”. Spine J 10:571–572. doi:10.​1016/​j.​spinee.​2010.​03.​002 (author reply 572) CrossRefPubMed
9.
go back to reference Kjaer P, Leboeuf-Yde C, Korsholm L, Sorensen JS, Bendix T (2005) Magnetic resonance imaging and low back pain in adults: a diagnostic imaging study of 40-year-old men and women. Spine (Phila Pa 1976) 30:1173–1180CrossRef Kjaer P, Leboeuf-Yde C, Korsholm L, Sorensen JS, Bendix T (2005) Magnetic resonance imaging and low back pain in adults: a diagnostic imaging study of 40-year-old men and women. Spine (Phila Pa 1976) 30:1173–1180CrossRef
12.
go back to reference Yuan W, Xia Y, Bell CG, Yet I, Ferreira T, Ward KJ, Gao F, Loomis AK, Hyde CL, Wu H, Lu H, Liu Y, Small KS, Vinuela A, Morris AP, Berdasco M, Esteller M, Brosnan MJ, Deloukas P, McCarthy MI, John SL, Bell JT, Wang J, Spector TD (2014) An integrated epigenomic analysis for type 2 diabetes susceptibility loci in monozygotic twins. Nat Commun 5:5719. doi:10.1038/ncomms6719 CrossRefPubMedPubMedCentral Yuan W, Xia Y, Bell CG, Yet I, Ferreira T, Ward KJ, Gao F, Loomis AK, Hyde CL, Wu H, Lu H, Liu Y, Small KS, Vinuela A, Morris AP, Berdasco M, Esteller M, Brosnan MJ, Deloukas P, McCarthy MI, John SL, Bell JT, Wang J, Spector TD (2014) An integrated epigenomic analysis for type 2 diabetes susceptibility loci in monozygotic twins. Nat Commun 5:5719. doi:10.​1038/​ncomms6719 CrossRefPubMedPubMedCentral
15.
go back to reference Videman T, Battie MC, Gibbons LE, Kaprio J, Koskenvuo M, Kannus P, Raininko R, Manninen H (2000) Disc degeneration and bone density in monozygotic twins discordant for insulin-dependent diabetes mellitus. J Orthop Res 18:768–772. doi:10.1002/jor.1100180514 CrossRefPubMed Videman T, Battie MC, Gibbons LE, Kaprio J, Koskenvuo M, Kannus P, Raininko R, Manninen H (2000) Disc degeneration and bone density in monozygotic twins discordant for insulin-dependent diabetes mellitus. J Orthop Res 18:768–772. doi:10.​1002/​jor.​1100180514 CrossRefPubMed
Metadata
Title
Does type 2 diabetes mellitus promote intervertebral disc degeneration?
Authors
Stella Maris Fabiane
Kirsten J. Ward
James C. Iatridis
Frances M. K. Williams
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 9/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-016-4612-3

Other articles of this Issue 9/2016

European Spine Journal 9/2016 Go to the issue