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Connection observed between abdominal obesity and lumbar disc degeneration
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 Jani Takatalo |
GOTHENBURG, Sweden — Sagittal abdominal diameter on MRI as a representation of abdominal obesity is positively associated with lumbar disc degeneration, according to Finnish investigators who presented at the International Society for the Study of the Lumbar Spine 38th Annual Meeting here.
“Disc degeneration (DD) is associated with high sagittal measurements on MRI among males and to our knowledge it’s the first published finding on the association of DD and abdominal adiposity on MRI,” Jani Takatalo, of Oulu, Finland, said.
In all, Takatalo and colleagues identified for their population-based study 325 women and 233 men from the area of Finland near Oulu aged 18 years who were previously identified for another study. They invited them to participate in the investigation by mailing them a questionnaire, conducting follow-up examinations when they were 19 years old and having them undergo lumbar MRIs.
Investigators used the MRIs to grade the amount of DD in each lumbar disc via modified Pfirrmann grading. Normal discs equaled 0, grade 3 DD equaled 1, grade 4 equaled 2 and grade 5 equaled 3. Adding all the scores for each subject, they arrived at a sum total DD score. According to Takatalo, 46% of subjects did not have DD and 16% of them had a sum score of 3.
“Low grade DD is common among young adults,” he noted, saying his group’s previous study found a positive association between high body mass index and DD in 21-year-old subjects.
Takatalo and colleagues then based abdominal obesity on the MRI measurements of dorsal subcutaneous thickness, abdominal cavity diameter and sagittal abdominal diameter at the subjects’ L3 or L4 levels and correlated those findings with the DD detected to draw their conclusions.
While in young males there was an association between sagittal abdominal diameter and DD, the investigators did not detect the same relationship in the women.
“The gender differences … warrant further study,” Takatalo said.
Reference:
- Takatalo J, Karppinen J, Taimela S, et al. The association of abdominal obesity on magnetic resonance imaging with lumbar disc degeneration among young adults. Paper #P15. Presented at the International Society for the Study of the Lumbar Spine Annual Meeting 2011. June 14-18. Gothenburg, Sweden.
Disc degeneration is multifactorial. Obesity is multifactorial and there is a confounding interaction between those two that you really have to look into. I really like the population studies, but we have to think interdisciplinary. So working together, for instance, with internal medicine, who are very keen on high cholesterol, diabetes regulation and weight care I think we can get to the real clinical importance of these kinds of studies and just saying somebody has abdominal fat that is biomechanically bad is taking the corner a bit too sharply.
— K.P. Paul
VU University Medical
Center
Department of Orthopaedic Surgery
Amsterdam
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