The association of lumbar intervertebral disc degeneration on magnetic resonance imaging with body mass index in overweight and obese adults: A population-based study

• Published in: Arthritis & rheumatology (Hoboken, N.J.) N.J.), 2012-05, Vol.64 (5), p.1488-1496
• Main Authors: Samartzis, Dino, Karppinen, Jaro, Chan, Danny, Luk, Keith D. K., Cheung, Kenneth M. C.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Body Mass Index; Comorbidity; Confidence intervals; Diseases of the osteoarticular system; Diseases of the spine; Female; Hong Kong - epidemiology; Humans; Intervertebral Disc Degeneration - epidemiology; Intervertebral Disc Degeneration - pathology; Lumbar Vertebrae - pathology; Magnetic Resonance Imaging - methods; Male; Medical sciences; Metabolic diseases; Middle Aged; NMR; Nuclear magnetic resonance; Obesity; Obesity - epidemiology; Obesity - pathology; Overweight - epidemiology; Overweight - pathology; Population Surveillance; Weight control; Young Adult
• ISSN: 0004-3591; 2326-5191; 1529-0131; 2326-5205
• DOI: 10.1002/art.33462

Objective To investigate the association of being overweight or obese with the presence, extent, and severity of lumbar disc degeneration on magnetic resonance imaging (MRI) in adults. Methods A population‐based cross‐sectional study of 2,599 southern Chinese volunteers was conducted. Subjects underwent radiographic and clinical assessment, and weight and height were measured. Sagittal T2‐weighted MRIs of the lumbar spine were obtained. The presence, extent, and severity of disc degeneration and additional radiographic and clinical parameters were assessed. Asian‐modified body mass index (BMI) (kg/m2) categories were used. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. Results The study included 1,040 men and 1,559 women (mean age 41.9 years). Disc degeneration was noted in 1,890 subjects (72.7%). BMI was significantly higher in subjects with disc degeneration (mean 23.3 kg/m2) than in subjects without degeneration (mean 21.7 kg/m2) (P < 0.001). A significant increase in the number of degenerated levels (P < 0.001), global severity of disc degeneration (P < 0.001), and end‐stage disc degeneration with disc space narrowing (P < 0.001) was noted with elevated BMI, in particular in overweight and obese subjects. In the adjusted multivariate logistic regression model, there was a positive linear trend (r2 = 0.99) between BMI and the overall presence of disc degeneration in overweight (OR 1.30 [95% CI 1.03–1.62]) and obese (OR 1.79 [95% CI 1.17–2.74]) subjects. End‐stage disc degeneration with disc space narrowing was significantly more pronounced in obese subjects (adjusted OR 1.72 [95% CI 1.23–2.41] [reference normal weight]). Conclusion Our findings, in one of the largest studies to systematically assess lumbar disc degeneration on MRI, indicated a significant association between the presence, extent, and global severity of disc degeneration with weight in overweight and obese adults.