Lifestyle factors and lumbar disc disease: results of a German multi-center case-control study (EPILIFT).
BACKGROUND
In the large-scale case-control study EPILIFT, we investigated the dose-response relationship between lifestyle factors (weight, smoking amount, cumulative duration of different sports activities) and lumbar disc disease.


METHODS
In four German study regions (Frankfurt am Main, Freiburg, Halle/Saale, Regensburg), 564 male and female patients with lumbar disc herniation and 351 patients with lumbar disc narrowing (chondrosis) aged 25 to 70 years were prospectively recruited. From the regional population registers, 901 population control subjects were randomly selected. In a structured personal interview, we enquired as to body weight at different ages, body height, cumulative smoking amount and cumulative duration of different sports activities. Confounders were selected according to biological plausibility and to the change-in-estimate criterion. Adjusted, gender-stratified odds ratios with 95% confidence intervals were calculated using unconditional logistic regression analysis.


RESULTS
The results of this case-control study reveal a positive association between weight and lumbar disc herniation as well as lumbar disc narrowing among men and women. A medium amount of pack-years was associated with lumbar disc herniation and narrowing in men and women. A non-significantly lowered risk of lumbar disc disease was found in men with high levels of cumulative body building and strength training.


CONCLUSIONS
According to our multi-center case-control study, body weight might be related to lumbar disc herniation as well as to lumbar disc narrowing. Further research should clarify the potential protective role of body building or strength training on lumbar disc disease.
Schumann
Barbara
B
Federal Institute for Occupational Safety and Health, Nöldnerstraße 40-42, 10317 Berlin, Germany. barbara.schumann@web.de
Bolm-Audorff
Ulrich
U
Bergmann
Annekatrin
A
Ellegast
Rolf
R
Elsner
Gine
G
Grifka
Joachim
J
Haerting
Johannes
J
Jäger
Matthias
M
Michaelis
Martina
M
Seidler
Andreas
A
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D016022:Case-Control Studies; D015444:Exercise; D005260:Female; D005858:Germany; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology*; D007405:Intervertebral Disc Displacement / Q000209:etiology*; D008019:Life Style; D008159:Lumbar Vertebrae / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013122:Spinal Diseases / Q000209:etiology; D013177:Sports