157 – METABOLIC SYNDROME INCREASES THE RISK OF PREVALENT SPINE OSTEOARTHRITIS

Abstract

Purpose: MetS has been shown to be a risk factor for chronic diseases such as cardiovascular diseases (CVD), including myocardial infarction and stroke, and dementia. Moreover, the risk factors that make up the MetS (central obesity, diabetes, high blood pressure, and dyslipidemia) have also been demonstrated to have independent relationships to degenerative joint disease. The relationship between the metabolic factors and spine OA have been examined by few, however the predictive value of MetS on the incidence or prevalence of this disease has not been studied. In this study, we asked whether the prevalence of spinal OA increases with the number of MS risk factors.

Method: We reviewed data from a single surgeon, high volume, spine surgery practice between the years of 2002–2007. Demographic data including the components of the MetS risk factors were collected. Prevalent severe OA was defined as degenerative spondylolisthesis or cervical or lumbar stenosis causing neurologically based symptoms, and early OA as those with lumbar and cervical spondylosis causing axial pain only. Logistic regression modeling was used to determine the odds (adjusted for age and sex) of having severe spine OA with an increasing number of the MetS risk factors.

Results: In our cohort of 1502 patients, there were 839/1502 (55.9%) patients defined as severe spinal OA and 663/839 (44.1%) patients with early OA. Those with severe spinal OA were significantly older, with a greater percentage of females, and had a greater BMI than those with early spinal OA (p < .05). The prevalence of severe spinal OA varied across groups defined by the number of MetS risk factors: 353/748 (47.2%) in those with 0 MetS risk factors, 236/392 (60.2 %) in those with 1 MetS risk factors, 148/228 (64.9 %) in those with 2 MetS risk factors, 76/104 (73.1 %) in those with 3 MetS risk factors, and 26/30 (86.7 %) in those with all 4 MetS risk factors. The overall prevalence of MetS was 30/1502 (2.0%), 26/839 (3.1%) in the severe OA group and 4/663 (0.6%) in the early OA group.(p= .001) Logistic regression modeling showed the odds of having severe spinal OA increased with an increasing number of MetS risk factors relative to having no MetS risk factors. Those patients having defined as MetS had almost a 4 times greater odds of having severe spinal OA as compared to those with no MetS risk factors, adjusted for age and gender [OR 3.9,(1.4, 11.6), p= .01].

Conclusion: The components of MetS are more prevalent in those with severe spinal OA causing neurological symptoms compared to those with spondylosis causing axial pain. Future work should examine for an association between MetS and incident OA.