Strong association of type 2 diabetes with degenerative lumbar spine disorders

Abstract

Tantalizing connections between type 2 diabetes and degenerative lumbar spine disorders have become increasingly evident. However, the association of type 2 diabetes with degenerative lumbar spine disorders remains unclear. We sought to clarify the association between type 2 diabetes and lumbar spine disorders using nationwide data in Korea. Furthermore, we explored the association of diabetes with the prevalence of spinal procedures. The data in this study was obtained from Korean health claim database. Between 2016 and 2019, totals of 479,680 diabetes and 479,680 age- and sex-matched control subjects were enrolled. Patients with diabetes had more likely to have degenerative lumbar spine disorders and spinal procedures than controls. Using multivariate-adjusted analysis, patients with diabetes were at increased risk of being concomitantly affected by lumbar disc disorder [adjusted odds ratio 1.11 (95% confidence interval 1.10-1.12)], lumbar spondylotic radiculopathy [1.12 (1.11-1.13)], spondylolisthesis [1.05 (1.02-1.08)] and spinal stenosis [1.16 (1.15-1.18)], compared to controls. Furthermore, diabetic patients had an increased risk of undergoing lumbar spinal injection [1.13 (1.12-1.14)], laminectomy [1.19 (1.15-1.23)], and fusion surgery [1.35 (1.29-1.42)]. We demonstrated that type 2 diabetes was significantly associated with lumbar spine disorders and frequent spinal procedures. Our results suggest diabetes as a predisposing factor for lumbar spine disorders.

Figure 1

Selection of the study population.

Figure 2

Prevalence of (A) lumbar disc disorder, (B) spondylotic radiculopathy, (C) spondylolisthesis, (D) spinal stenosis in matched control and diabetic patients. *p < 0.0001.

Figure 3

Prevalence of (A) lumbar spinal injection, (B) lumbar laminectomy, and (C) fusion operation in matched control and diabetic patients. *p < 0.0001.

Figure 4

Association of complicated diabetes with (A) lumbar spine disorders and (B) spinal procedures compared with uncomplicated diabetes. Adjusted OR (95% CI) was estimated by multiple logistic regression analysis with adjustments for hypertension, chronic kidney disease, dyslipidemia, and the type of beneficiary. DM, diabetes mellitus; OR, odds ratio; CI, confidence interval.