Pineal gland calcification, lumbar intervertebral disc degeneration and abdominal aorta calcifying atherosclerosis correlate in low back pain subjects: A cross-sectional observational CT study

Turgut, Ahmet Tuncay; Sönmez, İclal; Çakıt, Burcu Duyur; Koşar, Pınar Nercis; Koşar, Uğur

doi:10.1016/j.pathophys.2007.12.001

Cited by 29 publications

(22 citation statements)

References 24 publications

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“…Our results are consistent with previous studies that reported cardiovascular diseases are associated with chronic LBP. Several studies have reported that, similar to our study results, cardiovascular diseases are related to LBP [11], [18] and lumbar disc degeneration[19]–[23] using the atherosclerosis hypothesis.…”

Section: Discussionsupporting

confidence: 91%

The Association between the History of Cardiovascular Diseases and Chronic Low Back Pain in South Koreans: A Cross-Sectional Study

Lee

Kim

et al. 2014

PLoS ONE

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BackgroundCardiovascular disease and related risk factors have been suggested as a mechanism leading to atherosclerosis of the lumbar vessels and consequent lumbar pain or sciatica. But there is continued controversy concerning its generalization. This study examined whether cardiovascular disease or its risk factors were associated with chronic low back pain (cLBP) in Koreans.MethodsHealth surveys and examinations were conducted on a nationally representative sample (n = 23,632) of Koreans. A total of 13,841 eligible participants (aged 20 to 89 years) were examined to determine the association between cardiovascular disease, the Framingham risk score, major cardiovascular risk factors (blood pressure, diabetes, cholesterol, and smoking habits) and chronic LBP.ResultsThe total prevalence of cLBP was 16.6% (men: 10.8%, women: 21.1%) and that in patients with a history of cardiovascular diseases was 36.6% (men: 26.5%, women: 47.1%). The results showed that patients’ medical history of cardiovascular disease was significantly associated with cLBP in both men and women when adjusted for covariates (men: OR 2.16; 95%CI 1.34∼3.49; women: OR 2.26; 95%CI 1.51∼3.38). No association was observed between cLBP and the Framingham risk score, medication for hyperlipemia, hypertension, diabetes, and major cardiovascular risk factors (systolic blood pressure, total cholesterol, high density lipoprotein cholesterol, triglycerides, glucose and smoking habits) in either men or women.ConclusionsThe prevalence of cLBP is correlated to a history of cardiovascular disease, but not to the major cardiovascular risk factors from the Framingham study. Further studies on whether these results were affected by psychological factors in patients with a history of cardiovascular diseases or whether new potential risk factors from the artery atherosclerosis hypothesis applying to Koreans exist are needed.

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Section: Discussionsupporting

confidence: 91%

The Association between the History of Cardiovascular Diseases and Chronic Low Back Pain in South Koreans: A Cross-Sectional Study

Lee

Kim

et al. 2014

PLoS ONE

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“…variety of additional potential etiologic factors have been reported, suggesting that the impetus for disc degeneration may be a complex, multifactorial process (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Nonetheless, the effects of such degeneration, if progressive, may lead to the development of low back pain with or without sciatica.…”

mentioning

confidence: 99%

“…Although addressing genetic, developmental, or other potential etiologic factors (e.g., environmental, systematic diseases, hormonal) (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) that have been suggested to be associated with disc degeneration goes beyond the nature of our study design, one should not dismiss the possibility that such factors may play a role in the manifestation of SLDD. Although a biomechanical component is suggested as contributing to disc degeneration in this context, the suggestion requires further investigation.…”

mentioning

confidence: 99%

Intervertebral disc degeneration: New insights based on “skipped” level disc pathology

Cheung¹,

Samartzis²,

Karppinen³

et al. 2010

Arthritis & Rheumatism

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Objective. Typically, age and abnormal physical loading ("wear and tear") have been associated with the development of intervertebral disc degeneration. In the past decade, various additional etiologic factors for disc degeneration have been sporadically reported in the literature; however, many investigators continue to place tremendous emphasis on the effects of age and biomechanics associated with disc degeneration. The aim of this study was to provide additional insight into the notion that age and biomechanics are key factors in the development of disc degeneration. To this end, we addressed the prevalence of and risk factors associated with a unique pattern of disc degeneration of the lumbar spine, "skipped" level (nonconsecutive) disc degeneration (SLDD).Methods. As part of a large genetics-based study in southern Chinese individuals (n ‫؍‬ 1,989), a crosssectional analysis was performed in subjects exhibiting disc degeneration in >2 levels (n ‫؍‬ 838) who were then categorized as having SLDD (n ‫؍‬ 174) or non-SLDD (contiguous, multilevel; n ‫؍‬ 664). Various radiographic parameters were assessed based on T2-weighted magnetic resonance imaging (MRI). Subject demographics were assessed, and univariate and multivariate logistic regression analyses were performed.Results. Overall, 8.7% of the whole population (n ‫؍‬ 1,989) had SLDD, while it was present in 20.8% of subjects with multilevel disc degeneration (n ‫؍‬ 838). SLDD was more prevalent in male subjects (adjusted odds ratio [OR] 1.48, 95% confidence interval [95% CI] 1.04-2.10, P ‫؍‬ 0.028). SLDD was significantly associated with the presence of Schmorl's nodes (adjusted OR 2.72, 95% CI 1.78-4.15, P < 0.001), which also presented in levels with no disc degeneration. A history of disc bulge/extrusion (P ‫؍‬ 0.004) and/or a history of back injury (P ‫؍‬ 0.010) was significantly associated with non-SLDD, and a greater degree of overall severity of disc degeneration was also associated with non-SLDD. Other demographic and MRI findings did not significantly differ between groups.Conclusion. To our knowledge, this report is the first to describe the prevalence and risk factors associated with SLDD. Our study challenges the paradigm that age and biomechanics are the key factors associated with the development of disc degeneration. Although age and biomechanical factors may play a role in the manifestation of disc degeneration, our novel findings of SLDD patterns provide further awareness of and support for the notion that additional etiologic factors may play a role in the development of disc degeneration. Such factors warrant further investigation to shed light on the cause of disc degeneration.

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“…We assessed AAC because AAC predicts mortality and cardiovascular events . Postmortem and clinical studies assessed the association between AAC and OA of the spine . Some , but not all , of the cross‐sectional studies showed an association between severe AAC and disc degeneration.…”

Section: Discussionmentioning

confidence: 99%

“…However, data on the association of disc degeneration with CVDs and abdominal aortic calcification (AAC) are scarce. Some , but not all , cross‐sectional studies have shown a link between severe AAC and disc degeneration. Only 1 prospective study showed that severe AAC predicted early disc degeneration .…”

mentioning

confidence: 99%

Association of Severe Disc Degeneration With All‐Cause Mortality and Abdominal Aortic Calcification Assessed Prospectively in Older Men: Findings of a Single‐Center Prospective Study of Osteoporosis in Men

Estublier

Chapurlat

Szulc

2015

Arthritis & Rheumatology

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Objective. To assess the association of disc degeneration with all-cause mortality and with the severity and rate of progression of abdominal aortic calcification (AAC) in older men.Methods. Men >50 years of age (n 5 766) underwent lateral spine radiography and blood collection and were monitored prospectively. We assessed the association of disc degeneration with all-cause mortality (at 10 years), AAC severity (at baseline), and AAC progression (at 7.5 years).Results. After adjustment for confounders, including AAC, the total overall grade score for AAC predicted all-cause mortality (hazard ratio [HR] 1.20 per SD increase [95% confidence interval (95% CI) 1.01-1.43]). The highest tertile of the total overall grade score was associated with higher mortality rates (39.3/ 1,000 person-years for a score of >8 versus 20.9/1,000 person-years for a score of 0-8; adjusted HR 1.47 [95% CI 1.05-2.06]). The odds of severe AAC (score of >5) increased with the total disc space narrowing score (adjusted HR 1.44 per SD [95% CI 1.11-1.87]). The highest tertile of the total disc space narrowing score was associated with higher odds of severe AAC (adjusted HR 2.42 versus the lowest tertile [95% CI 1.24-4.73]). The probability of long-term AAC stability decreased with an increasing total osteophyte score (adjusted HR 0.66 per SD [95% CI 0.49-0.88]). The highest tertile of the total osteophyte score was associated with a lower probability of AAC stability (adjusted HR 0.35 versus the lowest tertile [95% CI 0.18-0.71]).Conclusion. Older men with severe disc degeneration have greater AAC severity, faster AAC progression, and higher all-cause mortality rates.

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Pineal gland calcification, lumbar intervertebral disc degeneration and abdominal aorta calcifying atherosclerosis correlate in low back pain subjects: A cross-sectional observational CT study

Cited by 29 publications

References 24 publications

The Association between the History of Cardiovascular Diseases and Chronic Low Back Pain in South Koreans: A Cross-Sectional Study

The Association between the History of Cardiovascular Diseases and Chronic Low Back Pain in South Koreans: A Cross-Sectional Study

Intervertebral disc degeneration: New insights based on “skipped” level disc pathology

Association of Severe Disc Degeneration With All‐Cause Mortality and Abdominal Aortic Calcification Assessed Prospectively in Older Men: Findings of a Single‐Center Prospective Study of Osteoporosis in Men

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