Serum lipid levels are positively correlated with lumbar disc herniation—a retrospective study of 790 Chinese patients

Abstract

BackgroundAbnormal serum lipid levels have been shown to be associated with the occurrence of atherosclerosis, but little is known about the relationships of them with the risk of developing intervertebral disc degeneration (IVDD) in Chinese population.MethodsWe performed a case–control study to assess the relationship between serum lipid levels and lumbar disc degeneration. A total of 790 Chinese patients were recruited for this study at the time of hospitalization. We examined fasting serum lipid levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). 396 patients (235 men and 161 women; mean age: 41.07 years) underwent surgery for single-level lumbar disc herniation. A control group of 394 patients (225 men and 169 women; mean age: 42.1 years) underwent surgery for wounded lower limbs during the same period. Patients in the control group were collected randomly from among patients who were age- and sex-matched patients with the case group.ResultsPatients with lumbar disc herniation had significantly higher TC and LDL-C serum concentrations (P < 0.001 for both) than controls. Percentage of High-TC, High-TG, High-LDL-C, borderline High-TC and borderline High-LDL-C were significantly higher in the disc herniation group (P = 0.017, P = 0.002, P = 0.039, P =0.002 and P < 0.001, respectively). Ratios of TC/HDL-C and LDL-C/HDL-C were significantly associated with disc herniation (P < 0.001 for both). Logistic regression revealed that patients with higher serum LDL-C levels had a higher risk of disc herniation, in which odds ratio (OR) was 1.462 and confidence interval (CI) was 1.179 ~ 1.813. Moreover, patients with High-TG and borderline High-LDL-C had a higher probability of disc herniation (OR: 2.974, CI: 1.488 ~ 5.945, statistical power: 100 %; OR: 1.626, CI: 1.012 ~ 2.612, statistical power: 61.4 %, respectively). However, hyperlipidaemia did not seem to be associated with the herniated segment of the lumbar intervertebral disc (p = 0.374).ConclusionsThe present study suggests that dyslipidaemia may be associated with a higher risk of developing lumbar disc herniation. Serum lipid levels could be a useful predictor for intervertebral disc degeneration in Chinese population.

Possible involvement of the oxLDL/LOX-1 system in the pathogenesis and progression of human intervertebral disc degeneration or herniation

“…The progression of IVDs by serum lipids and atherosclerosis is thought to be associated with the decrease in nutrition caused by the narrowing of arteries, which indirectly leads to IVDD 14 , 26 . The IVD is located at the end of the nutrient chain, which makes it the first structure to suffer from insufficient nutrient supply 26 – 29 . However, whether lipids directly affect the structural destabilization of IVD matrix remains unclear.…”

Trans-ethnic polygenic analysis supports genetic overlaps of lumbar disc degeneration with height, body mass index, and bone mineral density

“…Previous studies also reported that increased level of LDL-C, TC and TG were associated with increased risk of LDH (Longo et al 2011, Zhang et al 2016, Leino-Arjas et al 2008.…”

“…In addition to age, sex, and environmental influences, LDD is also associated with several heritable risk factors including body mass index (BMI) (Liuke et al 2005, Samartzis et al 2011, Takatalo et al 2013, bone mineral density (BMD) (Harada et al 1998, Pye et al 2006, Wang et al 2011, and serum lipid levels (Leino-Arjas et al 2008, Longo et al 2011, Zhang et al 2016. But it is not fully clear if there is a genetic basis for these phenotype associations.…”

Is there a relationship between blood lipids and lumbar disc herniation in young Turkish adults?

“…As an example, although a previous study reported an association between serum TC and sciatic pain among men [ 21 ], in women, high TC levels were found to be associated with LDH [ 23 ], emphasizing the importance of controlling for sex effects. The study by Zhang et al [ 24 ] included patients with a similar mean age as our study, but with at 1 : 1.5 distribution of women to men. As we previously stated, the impact of menopause on the blood lipid profile and the interaction between atherosclerosis and symptomatic LDH need to be considered.…”