Relationship between body mass index and spinal pathology in community-dwelling older adults

• Published in: European spine journal 2023-02, Vol.32 (2), p.428-435
• Main Authors: Takeuchi, Yuichi, Takahashi, Shinji, Ohyama, Shoichiro, Hori, Yusuke, Tsujio, Tadao, Kotake, Shiro, Yabu, Akito, Hoshino, Masatoshi, Terai, Hidetomi, Kobayashi, Akio, Nakamura, Hiroaki
• Format: Article
• Language: English
• Subjects: Aged; Back pain; Body Mass Index; Body weight; Comorbidity; Degeneration; Degenerative disc disease; Female; Humans; Independent Living; Intervertebral Disc Degeneration; Intervertebral discs; Low back pain; Low Back Pain - epidemiology; Lumbar Vertebrae; Male; Medicine; Medicine & Public Health; Neurosurgery; Obesity; Obesity - complications; Obesity - epidemiology; Older people; Original Article; Overweight; Quality of Life; Regression analysis; Retrospective Studies; Spinal Fractures; Surgical Orthopedics; Vertebrae
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-022-07495-2

Purpose To clarify the relationship between body mass index (BMI) and spinal pathologies including spinal sagittal balance, back extensor strength (BES), paraspinal muscle mass, prevalent vertebral fracture, disc degeneration, Modic changes, low back pain, and quality of life (QOL) in community-dwelling older adults. Methods This study included 380 participants (age: ≥ 65 years, male/female: 152/228) from the Shiraniwa Study. Multivariate nonlinear regression analysis was used to investigate the relationship between BMI and sagittal vertical axis (SVA), BES, paraspinal muscle mass, visual analog scale (VAS) for low back pain, Oswestry Disability Index (ODI), and EuroQoL-5 Dimension (EQ5D) score after adjusting for sex, age, Hospital Anxiety and Depression Scale score, and Charlson Comorbidity Index. In addition, multiple logistic regression analysis was used to investigate the association between BMI and prevalent vertebral fracture, disc degeneration, and Modic changes. Results BMI was significantly correlated with SVA, BES, paraspinal muscle mass, VAS, ODI, and EQ5D score. The increase in BMI was associated with the deterioration of all outcomes, which accelerated when the BMI increased from approximately 22–23 kg/m 2 . Moreover, overweight/obesity was significantly correlated with disc degeneration and Modic changes. Conclusion Increased BMI is significantly associated with spinal pathologies such as SVA, BES, paraspinal muscle mass, VAS, QOL, disc degeneration, and Modic changes. The findings suggest that measures for controlling overweight and obesity among older adults can play an important role in the prevention and treatment of spinal pathologies.