期刊
RHEUMATOLOGY
卷 56, 期 7, 页码 1189-1199出版社
OXFORD UNIV PRESS
DOI: 10.1093/rheumatology/kex040
关键词
intervertebral disc; degenerative disease; population-based; multi-centre prevalence study; plane radiology; Kellgren-Lawrence grading; bone mineral density (BMD); reproducibility study; osteochondrosis intervertebralis; age range 50 plus years
类别
资金
- European Union Concerted Action Grant under Biomed-1 [BMH1CT920182]
- EU [C1PDCT925102, ERBC1PDCT 930105, 940229]
- UK Arthritis Research Campaign
- Medical Research Council [G9321536]
- UK National Osteoporosis Society
- European Foundation for Osteoporosis and Bone Disease
- Bundesministerium fur Forschung and Technologie, Germany
- NIHR
- EU's PECO program
- British Heart Foundation [RG/08/014/24067] Funding Source: researchfish
- Medical Research Council [MC_U147585819, U1475000001, MC_UU_12011/1, MR/L003120/1, MC_UP_A620_1014, MC_U147585827, MR/P020941/1, G0400491, MR/K006312/1, MC_U147585824] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0512-10165, NF-SI-0513-10073, NF-SI-0513-10085, NF-SI-0508-10082] Funding Source: researchfish
- MRC [MR/K006312/1, MC_U147585819, MR/P020941/1, G0400491, MR/L003120/1, MC_U147585827] Funding Source: UKRI
Objectives. To assess the prevalences across Europe of radiological indices of degenerative inter-vertebral disc disease (DDD); and to quantify their associations with, age, sex, physical anthropometry, areal BMD (aBMD) and change in aBMD with time. Methods. In the population-based European Prospective Osteoporosis Study, 27 age-stratified samples of men and women from across the continent aged 50+ years had standardized lateral radiographs of the lumbar and thoracic spine to evaluate the severity of DDD, using the Kellgren-Lawrence (KL) scale. Measurements of anterior, mid-body and posterior vertebral heights on all assessed vertebrae from T4 to L4 were used to generate indices of end-plate curvature. Results. Images from 10 132 participants (56% female, mean age 63.9 years) passed quality checks. Overall, 47% of men and women had DDD grade 3 or more in the lumbar spine and 36% in both thoracic and lumbar spine. Risk ratios for DDD grades 3 and 4, adjusted for age and anthropometric determinants, varied across a three-fold range between centres, yet prevalences were highly correlated in men and women. DDD was associated with flattened, non-ovoid inter-vertebral disc spaces. KL grade 4 and loss of inter-vertebral disc space were associated with higher spine aBMD. Conclusion. KL grades 3 and 4 are often used clinically to categorize radiological DDD. Highly variable European prevalences of radiologically defined DDD grades 3+ along with the large effects of age may have growing and geographically unequal health and economic impacts as the population ages. These data encourage further studies of potential genetic and environmental causes.
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