Abstract
BACKGROUND CONTEXT
Obesity and visceral fat have been implicated as potential factors in the pathogenesis
of the ossification of the posterior longitudinal ligament (OPLL); the details of
the factors involved in OPLL remain unclear.
PURPOSE
We aimed to determine the association between dyslipidemia and symptomatic OPLL.
STUDY DESIGN
Single institution cross-sectional study.
PATIENT SAMPLE
Data were collected from Japanese patients with OPLL (n=92) who underwent whole-spine
computed tomography scanning. Control data (n=246) without any spinal ligament ossification
were collected from 627 Japanese participants who underwent physical examination.
OUTCOME MEASURES
Baseline information and lipid parameters, including triglycerides (TG), high-density
lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) from
fasting blood samples were collected to assess the comorbidity of dyslipidemia.
METHODS
Patient data were collected from 2020 to 2022. Patients with dyslipidemia were defined
as those who were taking medication for dyslipidemia and who met one of the following
criteria: TG ≥150 mg/dL, LDL-C ≥140 mg/dL, and/or HDL-C <40 mg/dL. The factors associated
with OPLL development were evaluated using multivariate logistic regression analysis.
RESULTS
The comorbidity of dyslipidemia in the OPLL group was more than twice that in the
control group (71.7% and 35.4%, respectively). The mean body mass index (BMI) of the
OPLL group was significantly higher than that of the control group (27.2 kg/m2 and 23.0 kg/m2). Multivariate logistic regression analysis revealed that dyslipidemia was associated
with the development of OPLL (regression coefficient, 0.80; 95% confidence interval,
0.11–1.50). Additional risk factors included age, BMI, and diabetes mellitus.
CONCLUSIONS
We demonstrated a novel association between dyslipidemia and symptomatic OPLL development
using serum data. This suggests that visceral fat obesity or abnormal lipid metabolism
are associated with the mechanisms of onset and exacerbation of OPLL as well as focal
mechanical irritation due to being overweight.
Keywords
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References
- Ossification of the posterior longitudinal ligament in the cervical spine: a review.Int. Orthop. 2019; 43: 797-805
- Prevalence of ossification of the posterior longitudinal ligament of the cervical spine.Joint Bone Spine. 2008; 75: 471-474
- Prevalence and progression of radiographic ossification of the posterior longitudinal ligament and associated factors in the Japanese population: a 3-year follow-up of the ROAD study.Osteoporos. Int. 2014; 25: 1089-1098
- Ossification of the posterior longitudinal ligament: a review of literature.Asian Spine J. 2011; 5: 267-276
- Current topics in pharmacological research on bone metabolism: molecular basis of ectopic bone formation induced by mechanical stress.J Pharmacol Sci. 2006; 100: 201-204
- Ossification of the posterior longitudinal ligament: a review.Neurosurg Focus. 2011; 30: E1
- Association between vitamin A intake and disease severity in early-onset heterotopic ossification of the posterior longitudinal ligament of the spine.Global Spine J. 2021; 12: 1770-1780
- High body mass index after age 20 and diabetes mellitus are independent risk factors for ossification of the posterior longitudinal ligament of the spine in Japanese subjects: a case-control study in multiple hospitals.Spine (Phila Pa 1976). 2004; 29: 1006-1010
- Risk factors for progression of ossification of the posterior longitudinal ligament in asymptomatic subjects.J Neurosurg Spine. 2020; 33: 316-322
- Clinical characteristics of patients with thoracic myelopathy caused by ossification of the posterior longitudinal ligament.J. Bone Miner. Metab. 2020; 38: 63-69
- Close association between non-alcoholic fatty liver disease and ossification of the posterior longitudinal ligament of the spine.Sci Rep. 2021; 11: 17412
- High body mass index is associated with an increased risk of the onset and severity of ossification of spinal ligaments.Front Surg. 2022; 9941672
- Association between obesity and ossification of spinal ligaments in 622 asymptomatic subjects: a cross-sectional study.J. Bone Miner. Metab. 2022; 40: 337-347
- Non-alcoholic fatty liver disease and dyslipidemia: an update.Metabolism. 2016; 65: 1109-1123
- Dyslipidemia in obesity: mechanisms and potential targets.Nutrients. 2013; 5: 1218-1240
- Genetic testing in dyslipidemia: a scientific statement from the National Lipid Association.J Clin Lipidol. 2020; 14: 398-413
- The effects of the interaction between BMI and dyslipidemia on hypertension in adults.Sci Rep. 2022; 12: 927
- The lipid theory in the pathogenesis of calcific aortic stenosis.Nutr. Metab. Cardiovasc. Dis. 2015; 25: 519-525
- Wnt signaling and cellular metabolism in osteoblasts.Cell. Mol. Life Sci. 2017; 74: 1649-1657
- Dual effects of lipid metabolism on osteoblast function.Front Endocrinol (Lausanne). 2020; 11578194
- Obesity and dyslipidemia.Metabolism. 2019; 92: 71-81
- Plasma lipoproteins and apolipoproteins as predictors of cardiovascular risk and treatment benefit in the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER).Circulation. 2005; 112: 3058-3065
- Assessment of the LDL-C/HDL-C ratio as a predictor of one year clinical outcomes in patients with acute coronary syndromes after percutaneous coronary intervention and drug-eluting stent implantation.Lipids Health Dis. 2019; 18: 40
- Statins, high-density lipoprotein cholesterol, and regression of coronary atherosclerosis.JAMA. 2007; 297: 499-508
- Role of the low-density lipoprotein-cholesterol/high-density lipoprotein-cholesterol ratio in predicting serial changes in the lipid component of coronary plaque.Circ J. 2017; 81: 1439-1446
- Executive summary of Japan Atherosclerosis Society (JAS) guideline for diagnosis and prevention of atherosclerotic cardiovascular diseases for Japanese.J. Atheroscler Thromb. 2007; 14: 45-50
- Sleeping habit and other life styles in the prime of life and risk for ossification of the posterior longitudinal ligament of the spine (OPLL): a case-control study in Japan.J. Epidemiol. 2004; 14: 168-173
- Distinct progression pattern of ossification of the posterior longitudinal ligament of the thoracic spine versus the cervical spine: a longitudinal whole-spine CT study.J Neurosurg Spine. 2022; 37: 175-182
Ministry of Health, Labor and Welfare. National health and nutrition survey, Available at: https://www.mhlw.go.jp/content/001066903.pdf accessed May 28, 2023.
- Ligamentous ossification of the cervical spine in the late middle-aged Japanese men. Its relation to body mass index and glucose metabolism.Spine (Phila Pa 1976). 1996; 21: 2474-2478
- Insulin secretory response is positively associated with the extent of ossification of the posterior longitudinal ligament of the spine.J. Bone Joint Surg. Am. 2001; 83: 1537-1544
- Characterization of glycosaminoglycans in ossified human yellow ligament.Connect Tissue. 1992; 24: 109-114
- Interaction between proteoglycans and alpha-elastin in construction of extracellular matrix of human yellow ligament.Connect. Tissue Res. 2005; 46: 67-73
- Obesity and calcification of the ligaments of the spine: a comprehensive CT analysis of the entire spine in a random trauma population.Spine J. 2019; 19: 1346-1353
- Prevalence, concomitance, and distribution of ossification of the spinal ligaments: results of whole spine CT scans in 1500 Japanese patients.Spine (Phila Pa 1976). 2016; 41: 1668-1676
- Prevalence, distribution, and morphology of thoracic ossification of the posterior longitudinal ligament in Japanese: results of CT-based cross-sectional study.Spine (Phila Pa 1976). 2014; 39: 394-399
Article info
Publication history
Published online: May 07, 2023
Publication stage
In Press Journal Pre-ProofFootnotes
FDA device/drug status: Not applicable
Author disclosures: SF: Nothing to disclose. TE: Nothing to disclose. MT: Nothing to disclose. MK: Nothing to disclose. YK: Nothing to disclose. RF: Nothing to disclose. RS: Nothing to disclose. TM: Nothing to disclose. TH: Nothing to disclose. MT: Nothing to disclose. TH: Nothing to disclose. KY: Nothing to disclose. HS: Nothing to disclose. KK: Nothing to disclose. NI: Nothing to disclose.
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