Strong association of lumbar disk herniation with diabetes mellitus: a 12-year nationwide retrospective cohort study
BackgroundDespite reports on the association between diabetes mellitus (DM) and lumbar disk herniation (LDH), large-scale, nationwide studies exploring this relationship are lacking. We aimed to examine the profiles of DM in individuals with LDH and explore the potential mechanisms underlying the de...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-11-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1260566/full |
| _version_ | 1827773667495378944 |
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| author | Jing-Xing Li Jing-Xing Li Jing-Xing Li Tzu-Ju Hsu Shu-Bai Hsu Shu-Bai Hsu Yu-Hsiang Lin Yu-Hsiang Lin |
| author_facet | Jing-Xing Li Jing-Xing Li Jing-Xing Li Tzu-Ju Hsu Shu-Bai Hsu Shu-Bai Hsu Yu-Hsiang Lin Yu-Hsiang Lin |
| author_sort | Jing-Xing Li |
| collection | DOAJ |
| description | BackgroundDespite reports on the association between diabetes mellitus (DM) and lumbar disk herniation (LDH), large-scale, nationwide studies exploring this relationship are lacking. We aimed to examine the profiles of DM in individuals with LDH and explore the potential mechanisms underlying the development of these disorders.MethodsThis retrospective, population-based study was conducted between 2008 and 2019 using data from the National Health Insurance (NHI) research database in Taiwan. The primary outcome was the date of initial LDH diagnosis, death, withdrawal from the NHI program, or end of the study period.ResultsIn total, 2,662,930 individuals with and 16,922,546 individuals without DM were included in this study; 719,068 matched pairs were established following propensity score matching (1:1 ratio) for sex, age, comorbidities, smoking, alcohol consumption, antihyperglycemic medications, and index year. The adjusted risk for developing LDH was 2.33-fold (95% confidence interval: 2.29−2.37; P<0.001), age-stratified analysis revealed a significantly greater risk of LDH in every age group, and both males and females were approximately twice as likely to develop LDH in the DM compared with non-DM cohort. Individuals with DM and comorbidities had a significantly higher risk of developing LDH than those without, and the serial models yielded consistent results. Treatment with metformin, sulfonylureas, meglitinides, thiazolidinediones, dipeptidyl peptidase-4 inhibitors, or alpha-glucosidase inhibitors was associated with a more than 4-fold increased risk of LDH in the DM cohort. DM was strongly associated with the long-term development of LDH; over the 12-year follow-up period, the cumulative risk of LDH was significantly higher in patients with than without DM (log-rank P<0.001).ConclusionDM is associated with an increased risk of LDH, and advanced DM may indicate a higher risk of LDH. |
| first_indexed | 2024-03-11T13:27:08Z |
| format | Article |
| id | doaj.art-100b92f76e864d378d80f012b85e2442 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-11T13:27:08Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-100b92f76e864d378d80f012b85e24422023-11-03T05:53:43ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-11-011410.3389/fendo.2023.12605661260566Strong association of lumbar disk herniation with diabetes mellitus: a 12-year nationwide retrospective cohort studyJing-Xing Li0Jing-Xing Li1Jing-Xing Li2Tzu-Ju Hsu3Shu-Bai Hsu4Shu-Bai Hsu5Yu-Hsiang Lin6Yu-Hsiang Lin7Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine, China Medical University, Taichung, TaiwanGraduate Institute of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University, Taipei, TaiwanManagement Office for Health Data, China Medical University Hospital, Taichung, TaiwanCollege of Medicine, China Medical University, Taichung, TaiwanDepartment of Nursing, China Medical University Hospital, Taichung, TaiwanSchool of Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Neurosurgery, China Medical University Hospital, Taichung, TaiwanBackgroundDespite reports on the association between diabetes mellitus (DM) and lumbar disk herniation (LDH), large-scale, nationwide studies exploring this relationship are lacking. We aimed to examine the profiles of DM in individuals with LDH and explore the potential mechanisms underlying the development of these disorders.MethodsThis retrospective, population-based study was conducted between 2008 and 2019 using data from the National Health Insurance (NHI) research database in Taiwan. The primary outcome was the date of initial LDH diagnosis, death, withdrawal from the NHI program, or end of the study period.ResultsIn total, 2,662,930 individuals with and 16,922,546 individuals without DM were included in this study; 719,068 matched pairs were established following propensity score matching (1:1 ratio) for sex, age, comorbidities, smoking, alcohol consumption, antihyperglycemic medications, and index year. The adjusted risk for developing LDH was 2.33-fold (95% confidence interval: 2.29−2.37; P<0.001), age-stratified analysis revealed a significantly greater risk of LDH in every age group, and both males and females were approximately twice as likely to develop LDH in the DM compared with non-DM cohort. Individuals with DM and comorbidities had a significantly higher risk of developing LDH than those without, and the serial models yielded consistent results. Treatment with metformin, sulfonylureas, meglitinides, thiazolidinediones, dipeptidyl peptidase-4 inhibitors, or alpha-glucosidase inhibitors was associated with a more than 4-fold increased risk of LDH in the DM cohort. DM was strongly associated with the long-term development of LDH; over the 12-year follow-up period, the cumulative risk of LDH was significantly higher in patients with than without DM (log-rank P<0.001).ConclusionDM is associated with an increased risk of LDH, and advanced DM may indicate a higher risk of LDH.https://www.frontiersin.org/articles/10.3389/fendo.2023.1260566/fulldiabetes mellituslumbar disk herniationintervertebral degenerative disk diseaseanti-diabetic medicationschronic back pain |
| spellingShingle | Jing-Xing Li Jing-Xing Li Jing-Xing Li Tzu-Ju Hsu Shu-Bai Hsu Shu-Bai Hsu Yu-Hsiang Lin Yu-Hsiang Lin Strong association of lumbar disk herniation with diabetes mellitus: a 12-year nationwide retrospective cohort study Frontiers in Endocrinology diabetes mellitus lumbar disk herniation intervertebral degenerative disk disease anti-diabetic medications chronic back pain |
| title | Strong association of lumbar disk herniation with diabetes mellitus: a 12-year nationwide retrospective cohort study |
| title_full | Strong association of lumbar disk herniation with diabetes mellitus: a 12-year nationwide retrospective cohort study |
| title_fullStr | Strong association of lumbar disk herniation with diabetes mellitus: a 12-year nationwide retrospective cohort study |
| title_full_unstemmed | Strong association of lumbar disk herniation with diabetes mellitus: a 12-year nationwide retrospective cohort study |
| title_short | Strong association of lumbar disk herniation with diabetes mellitus: a 12-year nationwide retrospective cohort study |
| title_sort | strong association of lumbar disk herniation with diabetes mellitus a 12 year nationwide retrospective cohort study |
| topic | diabetes mellitus lumbar disk herniation intervertebral degenerative disk disease anti-diabetic medications chronic back pain |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1260566/full |
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