High Body Mass Index Is Associated with an Increased Risk of the Onset and Severity of Ossification of Spinal Ligaments

Abstract

BackgroundOssification of the posterior longitudinal ligament (OPLL) and that of ligamentum flavum (OLF) are the main types of the ossification of spinal ligaments (OSL) that cause the thoracic myelopathy. Although several studies have investigated the relationship of body mass index (BMI) with the onset or severity of OSL, it remains unverified due to the contradictory results of existing evidence. A systematic review and meta-analysis were performed in this work to determine the relationship of BMI with the onset and severity of OSL.MethodsPubMed, EMBASE, Web of Science, and Cochrane Library were comprehensively searched online for relevant studies focusing on the relationship of BMI with the onset or severity of the OSL. The difference in BMI of OSL (or severe OSL group) and non-OSL (or nonsevere OSL group) groups was evaluated using the mean difference (MD) with a corresponding 95% confidence interval (CI).ResultsFifteen studies were included in this systematic review and meta-analysis. The BMI of the OSL group was significantly higher than that of the non-OSL group (MD = 1.70 kg/m2, 95% CI = 1.02–2.39 kg/m2, and P < 0.01). Similar results were observed in the subgroup analysis of female (P < 0.01), OPLL (P < 0.01), and OLF (P < 0.01) populations. Three studies reported a significant association of BMI with the ossification index of OSL and the standardized regression coefficient ranging from 0.11 to 0.43 (P < 0.05). Moreover, a significantly higher BMI was observed in the severe OSL group compared with that in the nonsevere OSL group (MD = 3.09, 95% CI, 0.22–5.97 kg/m2, and P = 0.04).ConclusionThe significant association of high BMI with the onset and severity of OSL may provide new evidence and insights into the mechanism research and management of OSL.

The relationship between body mass index and lower extremity biomechanics in children aged 10-12 years: a comprehensive analysis

“…These findings contrast with the results of previous studies that have found associations between BMI and foot position (Molina-García et al, 2023;Escalona-Marfil et al, 2022;Bann et al, 2022). Other study showed that subjects with higher BMI were at higher risk of ossification of the posterior longitudinal ligament and the yellow ligament of the spine, which may affect foot position (Zhao et al, 2022). In our study, we did not record variables relating to these spinal ligaments.…”

Multilevel ossification of the posterior longitudinal ligament causing cervical myelopathy: An observational series of North American patients

“…Several studies have reported the impact of obesity and diabetes on cervical OPLL. [ 3 4 14 15 16 ] A recent meta-analysis noted that patients with spinal ligament ossification had significantly higher BMI, and that patients with higher BMI had significantly higher ligament ossification indices and more severe disease presentation compared to those with lower BMI. [ 14 ] Kobashi et al .…”

“…[ 3 4 14 15 16 ] A recent meta-analysis noted that patients with spinal ligament ossification had significantly higher BMI, and that patients with higher BMI had significantly higher ligament ossification indices and more severe disease presentation compared to those with lower BMI. [ 14 ] Kobashi et al . noted that a history of diabetes mellitus and maximum BMI >25 kg/m 2 were independent risk factors for the development of OPLL.…”

Revealing the novel metabolism‐related genes in the ossification of the ligamentum flavum based on whole transcriptomic data

“… 10 , 20 In our previous study, we discovered that high body mass index might contribute to the onset and severity of the OLF. 21 , 22 Therefore, accumulating evidence showed that metabolic disorder might play a vital role in the pathogenesis of OLF. However, the value of metabolic disorder in OLF has not obtained adequate attention, and underlying mechanism remains unclear to date.…”